title: Acquired hypogonadotropic hypogonadism presenting as decreased seminal volume.
abstract: A 32-year-old man with decreased ejaculatory volume was found to have acquired hypogonadotropic hypogonadism. Initial evaluation demonstrated castrate levels of testosterone with low serum follicle-stimulating hormone (FSH) and luteinizing hormone (LH) levels. Semen analysis revealed a volume of 0.35 cc and severe oligospermia. Administration of gonadotropin-releasing hormone (GnRH) did not effect an increase in LH or FSH, indicating a pituitary defect. Magnetic resonance imaging revealed a partially empty sella turcica. Treatment with human chorionic gonadotropin (hCG) alone resulted in normalization of testosterone levels, sperm concentration, and semen volume, as well as the successful conception and delivery of a healthy baby girl. The findings from this case demonstrate the importance of considering low serum testosterone levels in the evaluation of low semen volume, as well as the role of hCG alone as an infertility treatment for acquired hypogonadotropic hypogonadism.
authors.affiliation: James Buchanan Brady Urology Foundation, Department of Urology, The New York Presbyterian Hospital-Weill Medical College of Cornell University, New York, New York, USA.
authors.forename: J A
authors.initials: JA
authors.lastname: Tash
authors.forename: J H
authors.initials: JH
authors.lastname: McGovern
authors.forename: P N
authors.initials: PN
authors.lastname: Schlegel
mesh_terms: D000328:Adult; D006063:Chorionic Gonadotropin / Q000008:administration & dosage; D004542:Ejaculation; D005640:Follicle Stimulating Hormone / Q000097:blood; D006801:Humans; D007006:Hypogonadism / Q000150:complications* / Q000175:diagnosis*; D007248:Infertility, Male / Q000188:drug therapy / Q000209:etiology*; D007986:Luteinizing Hormone / Q000097:blood; D008279:Magnetic Resonance Imaging; D008297:Male; D009845:Oligospermia / Q000209:etiology*; D012658:Sella Turcica / Q000473:pathology; D012661:Semen; D013739:Testosterone / Q000097:blood
chemical_list: D006063:Chorionic Gonadotropin; D013739:Testosterone; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone