Endocrine Abstracts

Background: Idiopathic Hypogonadotropic Hypogonadism (IHH) is a condition caused by deficiency or insensitivity to gonadotropin-releasing hormone where the pathology behind the mechanism is unknown and no secondary causes of hypogonadotropic hypogonadism are present. The condition not only effect sexual characteristic but can affect the physical and psychosocial development of a patient therefore making its prompt diagnoses and treatment necessary. The purpose of this study was to determine the sign, symptoms and laboratory parameters of the male IHH patients presenting in a tertiary setting.

Materials and Methods: This cross-sectional study was carried in Aga Khan University on male patients presenting with IHH to the Endocrinology clinic from December 2000 to December 2020. The patients presenting with signs or symptoms of hypogonadism, associated low sex steroid hormone and inappropriately low or normal gonadotropins with absent expansive hypothalamic or pituitary lesions or multiple pituitary hormone defects were included in the study. Quantitative variable was shown as Mean ± Standard Deviation while qualitative variables were shown as frequency and percentages.

Results: Data of 79 IHH patients was reviewed with Mean Age ± SD being 24.2 ± 7.5 years. Clinically 64 (81.0%) presented with small genitalia, 50 (63.6%) had absent secondary sexual characteristics, 53 (67.1%) presented with infertility, 44 (55.7%) had not attained puberty, 52 (65.8%) had erectile dysfunction, 46 (58.2%) with loss of libido, 11(13.9%) had a positive family history, 24 (30.3%) had gynecomastia, 9 (11.4%) had undescended testes and 6 (7.6%) had hyposmia or anosmia. The mean serum testosterone level of the patients was 26.3 ± 60 ηg/dl while mean FSH and LH level were 2.7 ± 5.0 and 1.3 ± 2.4 respectively.

Conclusion: It was observed that the primary complains of patients presenting with IHH were small genitalia, infertility, and absence of secondary sexual characteristics with a low serum testosterone level.

Keywords: Male Idiopathic Hypogonadotropic Hypogonadism (IHH), Infertility, Pakistan