Induction of puberty with human chorionic gonadotropin and follicle-stimulating hormone in adolescent males with hypogonadotropic hypogonadism

Abstract

Objective: To evaluate the clinical and hormonal responses of adolescent males with hypogonadotropic hypogonadism (HH) in response to gonadotropin replacement with the use of long-term combined hCG and FSH therapy. Design: Prospective clinical study. Setting: Clinical pediatric department providing tertiary care. Patient(s): Seven prepubertal males with isolated HH with a mean (±SD) age of 15.44 ± 1.97 years and seven prepubertal males with panhypopituitarism-associated HH with a mean (±SD) age of 18.1 ± 3.24 years were studied. Intervention(s): Human chorionic gonadotropin (1,000–1,500 IU IM) and FSH (75–100 IU SC) were administered every alternate day of the week until the total induction of puberty and spermatogenesis was achieved. Main Outcome Measure(s): Serum testosterone levels, testicular volume, penis length, and sperm count were evaluated after the administration of hCG and FSH. Result(s): All patients achieved normal sexual maturation and normal or nearly normal adult male levels of testosterone. The increase in testicular size was significant in both groups. Positive sperm production was assessed in four of five patients with isolated HH and in three of three patients with panhypopituitarism-associated HH. Conclusion(s): Long-term combined hCG and FSH therapy is effective in inducing puberty, increasing testicular volume, and stimulating spermatogenesis in adolescent males with isolated HH and panhypopituitarism-associated HH.