Select patients with hypogonadotropic hypogonadism may respond to treatment with clomiphene citrate.
OBJECTIVE
To review the management of male hypogonadotropic hypogonadism (HH) and evaluate the efficacy of clomiphene citrate (CC).


METHODS
Retrospective review.


METHODS
Two university-based urology clinics.


METHODS
Ten patients referred for male infertility evaluation.


METHODS
Patients were treated with either clomiphene citrate or injectable gonadotropins.


METHODS
Changes in seminal parameters, gonadotropin levels, serum testosterone, and pregnancy.


RESULTS
Ten men who were evaluated for infertility were diagnosed with HH. Four had Kallmann's syndrome, four idiopathic HH, and two panhypopituitarism. Eight patients were azoospermic, and two were oligospermic on presentation. Three of the four men with adult-onset idiopathic HH responded to CC alone with increases in testosterone, FSH, and LH. Semen parameters in this group also improved, and two of the three men achieved pregnancies with CC alone. Out of the ten men actively attempting conception, four pregnancies were achieved. Three pregnancies (two with CC and one with gonadotropins) were in men diagnosed with adult-onset idiopathic forms of HH.


CONCLUSIONS
Select patients with adult-onset idiopathic forms of HH may benefit from a trial of clomiphene citrate.
Whitten
Scott J
SJ
Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Alabama, Birmingham, Alabama 35249-7333, USA. sjwmd@yahoo.com <sjwmd@yahoo.com>
Nangia
Ajay K
AK
Kolettis
Peter N
PN
D000328:Adult; D002996:Clomiphene / Q000627:therapeutic use*; D004965:Estrogen Antagonists / Q000627:therapeutic use; D006801:Humans; D007006:Hypogonadism / Q000150:complications* / Q000188:drug therapy*; D007248:Infertility, Male / Q000209:etiology* / Q000517:prevention & control*; D008297:Male; D018579:Patient Selection; D012189:Retrospective Studies; D016896:Treatment Outcome
D004965:Estrogen Antagonists; D002996:Clomiphene