Verlaufskontrolle bei andrologischen Patienten unter HCG/HMG-Therapie unter besonderer Berücksichtigung des Spermiogramms und der somatischen Entwicklung

Abstract

Between 1971 and 1976, 47 patients were treated in the department for andrology with daily alternating HCG/HMG injections. This treatment provides an attempt for examination of effects of a combined HCG/HMG therapy with a larger group of patients. As a condition for the HCG/HMG treatment a testicular biopsy was performed. It could be shown that in 70% of the cases there was no normal tabulus diameter, that the germinal epithelium was mostly low, and that in the germinal epithelium in 53,8% of the cases a spermiogenesis was demonstrable, but only in 3% of the cases sufficient spermatozoa existed. Most of the patients presented a disorganisation and desquamation of the germinal epithelium. During treatment no further testicular biopsies were made so that no statements can be given on the change of the tubules. Concerning the observation of the patients' sperm count it could be proved that, as a result of the HCG/HMG treatment, 33,3% of the patients showed an increase of motility and in 37,5% of the patients the number of spermatozoa increased. The paper describes two patients showing normal sperm count already after 8 to 12 weeks. Furthermore de Kretsers' observations on large decrease of spermatozoal number after the 150th day of treatment, and Paulsens' observations on hot flushes in some patients due to interruption of treatment, could be confirmed. The somatic development during HCG/HMG treatment showed an increase of volume of the testicles and an increase of the secondary hair. These changes also appeared already within 12 weeks after the beginning of treatment. In 38,5% of studied cases erections and ejaculations appeared already after 8 to 12 weeks as far as this didn't occur before treatment. In four cases pregnancy resulted from treatment. There was one early abortion. In all other cases gravidity and birth were normal. Only in one case negative side effects as a lack of concentration resulted. This study provides evidence that an alternating HCG/HMG treatment can be quite successful. Gonadotropin levels and the result of testicular biopsy have to be considered for clinical evaluation of treatment and therapeutic results.