EC Gynaecology

Background: Androgen deficiency and infertility lead to male hypogonadism. The main purpose of this study was to evaluate pregnancy outcomes of a cohort of males with adult-onset hypogonadism (AOHH) after gonadotropin treatment with hCG/hMG.

Methods: This retrospective study included 17 patients from a group of 2,340 men referred to Zekai Tahir Burak Women’s Health Training and Research Hospital for evaluation of azoospermia. Final sperm concentration, serum luteinizing hormone (LH), follicle stimulating hormone (FSH), endogenous testosterone, and pregnancy rates were compared to baseline, and statistical significance was p < 0.05.

Results: The mean LH increased from 0.05 (0 - 0.6) to 0.07 (0.01 - 0.58) IU/liter (p = 0.59), and FSH increased from 0.42 (0 - 2.2) to 2.63 (1.48 - 7.03) IU/liter (p = 0.001). Mean serum endogenous testosterone increased from 714.4 ng per deciliter, and spermatogenesis was induced in all patients. Five patients who want sharing personal data excluded of the study, and of the remaining 12, pregnancy occurred in 42% (n = 5) of their partners, including 17% (n = 2) with spontaneous pregnancy. Nine of the couples (75%) underwent IVF treatment using intracytoplasmic sperm injection (ICSI) and three of these (25%) became pregnant. One pregnancy ended in spontaneous abortion at 9 weeks of gestation and the other four resulted in the delivery of normal offspring.

Conclusion: Spermatogenesis can be improved by gonadotropin treatment in male AOHH, and although semen quality is low after treatment, pregnancy may still occur in a significant portion of cases.

Keywords: Male Adult-Onset Hypogonadotropic Hypogonadism; Pregnancy; In Vitro Fertilization

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