Induction of ovulation and spermatogenesis by hMG/hCG in hypogonadotropic GH-deficient patients.
Nine female and 20 male hypogonadotropic GH-deficient patients were studied for sexual development by hCG/hMG. In the female patients, gonadotropin therapy was started at the mean age of 22.7 +/- 2.1 years. The administration of progesterone induced withdrawal bleeding at an average of 2.77 +/- 1.94 years after the initiation of hMG/hCG therapy in 8 of the 9 patients studied. Of 6 patients who had been confirmed as positive in a gestagen test, induction of ovulation by hMG/hCG was observed in 5 patients at an average of 5.58 +/- 1.23 years after the onset of therapy, but not in the remaining patient who had been given estrogen and progesterone 4 years 9 months prior to the initiation of the gonadotropin therapy. In male patients, gonadotropin therapy was started at the mean age of 23.6 +/- 5.7 years. Seminal fluid was obtained by masturbation and brought to our clinic in the morning. Of the 20 patients, 19 patients could be observed once a month regularly. Of the 19 patients, spermatozoa could be detected at a mean period of 2.19 +/- 0.87 years after initiation of hCG/hMG therapy in 18, but not in the remaining patient, after 5 years of therapy, who did not receive hCG/hMG regularly. The sperm count exceeded 20 x 10(6)/ml and more in 12 and was lower than that in 8 patients after 3 years of the therapy. No side effects were observed in female patients, but gynecomastia developed in 2 of the 20 male patients. These data suggest that gonadotropin therapy for hypogonadotropic GH-deficient patients is effective in promoting ovulation and spermatogenesis despite the initial replacement therapy with sex hormones.
Okada
Y
Y
Okada Clinic, Osaka, Japan.
Kondo
T
T
Okamoto
S
S
Ogawa
M
M
D000293:Adolescent; D000328:Adult; D006063:Chorionic Gonadotropin / Q000627:therapeutic use*; D005260:Female; D012739:Gonadal Steroid Hormones / Q000627:therapeutic use; D013006:Growth Hormone / Q000172:deficiency*; D006801:Humans; D007006:Hypogonadism / Q000188:drug therapy*; D008297:Male; D008596:Menotropins / Q000627:therapeutic use*; D010062:Ovulation Induction / Q000379:methods*; D011374:Progesterone; D013076:Sperm Count / Q000187:drug effects; D013091:Spermatogenesis / Q000187:drug effects*
D006063:Chorionic Gonadotropin; D012739:Gonadal Steroid Hormones; D011374:Progesterone; D008596:Menotropins; D013006:Growth Hormone