Pulsatile gonadotropin-releasing hormone therapy is associated with earlier spermatogenesis compared to combined gonadotropin therapy in patients with congenital hypogonadotropic hypogonadism
| العنوان: | Pulsatile gonadotropin-releasing hormone therapy is associated with earlier spermatogenesis compared to combined gonadotropin therapy in patients with congenital hypogonadotropic hypogonadism |
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| المؤلفون: | Zhaoxiang Liu, Jiangfeng Mao, Min Nie, Ursula B. Kaiser, Junjie Zheng, Le Min, Hongli Xu, Bingkun Huang, Xueyan Wu, Xi Wang |
| المصدر: | Asian Journal of Andrology Asian Journal of Andrology, Vol 19, Iss 6, Pp 680-685 (2017) |
| بيانات النشر: | Medknow Publications & Media Pvt Ltd, 2016. |
| سنة النشر: | 2016 |
| مصطلحات موضوعية: | Adult, Male, medicine.medical_specialty, endocrine system, Adolescent, medicine.drug_class, Urology, Pulsatile flow, 030209 endocrinology & metabolism, Gonadotropin-releasing hormone, lcsh:RC870-923, congenital hypogonadotropic hypogonadism, Drug Administration Schedule, Human chorionic gonadotropin, Gonadotropin-Releasing Hormone, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Internal medicine, pulsatile GnRH therapy, Testis, medicine, Humans, Testosterone, combined gonadotropin therapy, Retrospective Studies, 030219 obstetrics & reproductive medicine, Sperm Count, business.industry, Hypogonadism, spermatogenesis, Retrospective cohort study, General Medicine, Luteinizing Hormone, lcsh:Diseases of the genitourinary system. Urology, Endocrinology, Treatment Outcome, Sperm Motility, Original Article, Congenital Hypogonadotropic Hypogonadism, Gonadotropin, Follicle Stimulating Hormone, business, Spermatogenesis, hormones, hormone substitutes, and hormone antagonists, Hormone |
| الوصف: | Both pulsatile gonadotropin-releasing hormone (GnRH) infusion and combined gonadotropin therapy (human chorionic gonadotropin and human menopausal gonadotropin [HCG/HMG]) are effective to induce spermatogenesis in male patients with congenital hypogonadotropic hypogonadism (CHH). However, evidence is lacking as to which treatment strategy is better. This retrospective cohort study included 202 patients with CHH: twenty had received pulsatile GnRH and 182 had received HCG/HMG. Patients had received therapy for at least 12 months. The total follow-up time was 15.6 ± 5.0 months (range: 12-27 months) for the GnRH group and 28.7 ± 13.0 months (range: 12-66 months) for the HCG/HMG group. The median time to first sperm appearance was 6 months (95% confidence interval [CI]: 1.6-10.4) in the GnRH group versus 18 months (95% CI: 16.4-20.0) in the HCG/HMG group (P < 0.001). The median time to achieve sperm concentrations ≥5 × 10 6 ml−1 was 14 months (95% CI: 5.8-22.2) in the GnRH group versus 27 months (95% CI: 18.9-35.1) in the HCG/HMG group (P < 0.001), and the median time to concentrations ≥10 × 10 6 ml−1 was 18 months (95% CI: 10.0-26.0) in the GnRH group versus 39 months (95% CI unknown) in the HCG/HMG group. Compared to the GnRH group, the HCG/HMG group required longer treatment periods to achieve testicular sizes of ≥4 ml, ≥8 ml, ≥12 ml, and ≥16 ml. Sperm motility (a + b + c percentage) evaluated in semen samples with concentrations >1 × 10 6 ml−1 was 43.7% ± 20.4% (16 samples) in the GnRH group versus 43.2% ± 18.1% (153 samples) in the HCG/HMG group (P = 0.921). Notably, during follow-up, the GnRH group had lower serum testosterone levels than the HCG/HMG group (8.3 ± 4.6 vs 16.2 ± 8.2 nmol l−1 , P < 0.001). Our study found that pulsatile GnRH therapy was associated with earlier spermatogenesis and larger testicular size compared to combined gonadotropin therapy. Additional prospective randomized studies would be required to confirm these findings. |
| اللغة: | English |
| تدمد: | 1745-7262 1008-682X |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::f6e84d7b127b99d5f2d0c08fe48615bfTest http://europepmc.org/articles/PMC5676428Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....f6e84d7b127b99d5f2d0c08fe48615bf |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 17457262 1008682X |
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