Adult-onset idiopathic hypogonadotropic hypogonadism--a treatable form of male infertility
Details
Serval ID
serval:BIB_EE696D2CDFA9
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Adult-onset idiopathic hypogonadotropic hypogonadism--a treatable form of male infertility
Journal
New England Journal of Medicine
ISSN
0028-4793 (Print)
Publication state
Published
Issued date
02/1997
Volume
336
Number
6
Pages
410-5
Notes
Comparative Study
Journal Article
Research Support, U.S. Gov't, P.H.S. --- Old month value: Feb 6
Journal Article
Research Support, U.S. Gov't, P.H.S. --- Old month value: Feb 6
Abstract
BACKGROUND: Men with isolated gonadotropin-releasing hormone (GnRH) deficiency typically present with an absence of pubertal development. We describe an adult-onset form of idiopathic hypogonadotropic hypogonadism that develops after puberty. METHODS: We studied 10 men (age, 27 to 57 years) with normal sexual maturation, idiopathic infertility, sexual dysfunction, low serum testosterone concentrations, and apulsatile secretion of luteinizing hormone on frequent blood sampling. All the men had otherwise normal anterior pituitary hormone secretion and sellar anatomy. We compared the results of semen analyses and measurements of testicular volume, serum testosterone, inhibin B, and gonadotropins in these men with the results in 24 men with classic GnRH deficiency before and during GnRH-replacement therapy and in 29 normal men of similar age. RESULTS: Serum gonadotropin concentrations in the men with adult-onset GnRH deficiency were similar before and during pulsatile GnRH administration to those in the men with classic GnRH deficiency. However, as compared with men with classic GnRH deficiency, men with adult-onset hypogonadotropic hypogonadism had larger mean (+/-SD) testicular volumes (18+/-5 vs. 3+/-2 ml, P<0.001), serum testosterone concentrations (78+/-34 vs. 49+/-20 ng per deciliter [2.7+/-1.2 vs. 1.7+/-0.7 nmol per liter], P=0.004), and serum inhibin B concentrations (119+/-52 vs. 60+/-21 pg per milliliter, P<0.001). Treatment with GnRH reversed the hypogonadism and restored fertility in each of the five men who received long-term therapy. CONCLUSIONS: The recognition of adult-onset hypogonadotropic hypogonadism in men as a distinct disorder expands the spectrum of GnRH deficiency and identifies a treatable form of male infertility.
Keywords
Adult
Age of Onset
Gonadotropin-Releasing Hormone/blood/*deficiency/therapeutic use
Gonadotropins, Pituitary/blood
Humans
*Hypogonadism/blood/complications/drug therapy
Impotence/etiology
Infertility, Male/drug therapy/*etiology
Inhibins/blood
Libido
Male
Middle Aged
Reference Values
Testis/anatomy & histology
Testosterone/blood
Pubmed
Web of science
Create date
25/01/2008 17:26
Last modification date
20/08/2019 17:15