title: [Spermatogenesis of pulsatile gonadotropin-releasing hormone infusion versus gonadotropin therapy in male idiopathic hypogonadotropic hypogonadism].
abstract: OBJECTIVE
  To compare the efficacies of pulsatile gonadotropin-releasing hormone (GnRH) versus human chorionic gonadotropin/human menopausal gonadotropin (HCG/HMG) for spermatogenesis in male idiopathic hypogonadotropic hypogonadism (IHH).
  
  
  METHODS
  For this retrospective study, a total of 92 male IHH outpatients from May 2010 to October 2014 were recruited and categorized into GnRH (n = 40) and HCG/HMG (n = 52) groups. Each subject selected one specific therapy voluntarily. The gonadotropin levels were measured in the first week and monthly post-treatment in GnRH group. And serum total testosterone (TT), testicular volume (TV) and rate of spermatogenesis were observed monthly post-treatment in two groups. Spermatogenesis, TT and TV were compared between two groups.
  
  
  RESULTS
  All IHH patients were treated for over 3 months. The median follow-up periods in GnRH and HCG/HMG groups was 8.2 (3.0-18.4) and 9.2 (3.0-18.6) months respectively (P = 0.413). In GnRH group, LH ((0.5 ± 0.6) vs (3.4 ± 2.4) U/L, P < 0.01) and FSH ((1.3 ± 1.1) vs (5.8 ± 3.8) U/L, P < 0.01) increased after 1-week treatment. In GnRH group, at the end of follow-up, TT ((1.0 ± 1.0) vs (7.4 ± 5.2) nmol/L, P < 0.01) and TV ((2.3 ± 1.5) vs (8.1 ± 4.0) ml, P < 0.01) significantly increased compared to baseline. In HCG/HMG group, TT ((0.8 ± 0.6) vs (14.4 ± 8.0) nmol/L, P < 0.01) and TV ((2.3 ± 2.1) vs (7.6 ± 4.2) ml, P < 0.01) significantly increased after therapy. The success rate of spermatogenesis was 50.0% (20/40) in GnRH group versus 28.8% (15/52) in HCG/HMG group (P = 0.038). GnRH group required a shorter treatment time for initial sperm appearance than HCG/HMG group ((6.5 ± 3.1) vs (10.8 ± 3.7) months, P = 0.001).
  
  
  CONCLUSIONS
  Pulsatile GnRH requires a shorter time for initiation of spermatogenesis than gonadotropin therapy in IHH male patients.
authors.affiliation: Department of Endocrinology/Key Laboratory of Endocrinology, Ministry of Health, Peking Union Medical College Hospital & Chinese Academy of Medical Sciences, Beijing 100730, China.
authors.forename: Bingkun
authors.initials: B
authors.lastname: Huang
authors.affiliation: Department of Endocrinology/Key Laboratory of Endocrinology, Ministry of Health, Peking Union Medical College Hospital & Chinese Academy of Medical Sciences, Beijing 100730, China.
authors.forename: Jiangfeng
authors.initials: J
authors.lastname: Mao
authors.affiliation: Department of Endocrinology/Key Laboratory of Endocrinology, Ministry of Health, Peking Union Medical College Hospital & Chinese Academy of Medical Sciences, Beijing 100730, China.
authors.forename: Hongli
authors.initials: H
authors.lastname: Xu
authors.affiliation: Department of Endocrinology/Key Laboratory of Endocrinology, Ministry of Health, Peking Union Medical College Hospital & Chinese Academy of Medical Sciences, Beijing 100730, China.
authors.forename: Xi
authors.initials: X
authors.lastname: Wang
authors.affiliation: Department of Endocrinology/Key Laboratory of Endocrinology, Ministry of Health, Peking Union Medical College Hospital & Chinese Academy of Medical Sciences, Beijing 100730, China.
authors.forename: Zhaoxiang
authors.initials: Z
authors.lastname: Liu
authors.affiliation: Department of Endocrinology/Key Laboratory of Endocrinology, Ministry of Health, Peking Union Medical College Hospital & Chinese Academy of Medical Sciences, Beijing 100730, China.
authors.forename: Min
authors.initials: M
authors.lastname: Nie
authors.affiliation: Department of Endocrinology/Key Laboratory of Endocrinology, Ministry of Health, Peking Union Medical College Hospital & Chinese Academy of Medical Sciences, Beijing 100730, China; Email: wsheyan@vip.sina.com.
authors.forename: Xueyan
authors.initials: X
authors.lastname: Wu
mesh_terms: D006063:Chorionic Gonadotropin; D007987:Gonadotropin-Releasing Hormone; D006062:Gonadotropins; D006801:Humans; D007006:Hypogonadism; D008297:Male; D010045:Outpatients; D012189:Retrospective Studies; D013091:Spermatogenesis; D013737:Testis
chemical_list: D006063:Chorionic Gonadotropin; D006062:Gonadotropins; D007987:Gonadotropin-Releasing Hormone