Treatment of male infertility secondary to morbid obesity.
BACKGROUND
A 29-year-old man presented to a clinic with infertility and hypogonadism in the setting of morbid obesity. On presentation, he had notable gynecomastia and a low testicular volume. The patient's weight was 154 kg and his height was 168 cm (BMI 54.5 kg/m(2)). Before referral to the clinic, the patient had been treated with testosterone therapy for 4 months for hypogonadism. This treatment had caused his initially low sperm concentration to fall to undetectable levels.


METHODS
Measurement of reproductive hormone levels, pituitary MRI, and semen analysis.


METHODS
Infertility secondary to hypogonadotropic hypogonadism and an elevated estrogen:testosterone ratio.


RESULTS
Treatment with an aromatase inhibitor, anastrozole, led to normalization of the patient's testosterone, luteinizing hormone and follicle-stimulating hormone levels, suppression of serum estradiol levels, and to normalization of spermatogenesis and fertility.
Roth
Mara Y
MY
Division of Metabolism, Endocrinology and Nutrition, University of Washington School of Medicine, Seattle, WA 98195-6246, USA.
Amory
John K
JK
Page
Stephanie T
ST
D000328:Adult; D000077384:Anastrozole; D047072:Aromatase Inhibitors / Q000627:therapeutic use*; D005640:Follicle Stimulating Hormone / Q000097:blood; D006801:Humans; D007006:Hypogonadism / Q000097:blood / Q000150:complications* / Q000188:drug therapy; D007248:Infertility, Male / Q000097:blood / Q000150:complications* / Q000188:drug therapy*; D007986:Luteinizing Hormone / Q000097:blood; D008297:Male; D009570:Nitriles / Q000627:therapeutic use*; D009767:Obesity, Morbid / Q000097:blood / Q000150:complications*; D013091:Spermatogenesis / Q000187:drug effects / Q000502:physiology; D013739:Testosterone / Q000097:blood; D014230:Triazoles / Q000627:therapeutic use*
D047072:Aromatase Inhibitors; D009570:Nitriles; D014230:Triazoles; D000077384:Anastrozole; D013739:Testosterone; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone