EYES2024 ESE Young Endocrinologists and Scientists (EYES) 2024 Reproductive Endocrinology (10 abstracts)
Induction of spermatogenesis in men with hypogonadotropic hypogonadism
Andjela Boskovic 1 , Miomira Ivovic 1,2 , Milina Tancic Gajic 1,2 , Ljiljana Marina 1,2 , Veljko Pantovic 1 , Milica Jovanovic 1 , Natalija Pavlovic 1 , Zorana Arizanovic 1 , Taisa Bojovic 1 & Svetlana Vujovic 1,2
1National Centre for Infertility and Endocrinology of Gender Clinic for Endocrinology, Diabetes and Metabolic Diseases University Clinical Centre of Serbia, Belgrade, Serbia; 2Faculty of Medicine, University of Belgrade, Belgrade, Serbia
Introduction: Hypogonadotropic hypogonadism (HH) is a type of secondary hypogonadism. Congenital forms are distinguished, including Kallman's syndrome and Idiopathic hypogonadotropic hypogonadism (IHH), along with acquired forms. The incidence of HH in men is 1:10,000.
Case report: A 34-year-old male patient was hospitalized at our department in August 2023 due to primary infertility and sexual dysfunction (SD). The patient was referred to our clinic with results that showed azoospermia and a low testosterone (T) level of 1.72 nmol/l. During physical examination, a small volume of the testis (5 ml) and a spermatocele were found on the left (12 m). Additional stimulation tests (LHRH test and hCG test) were performed during hospitalization and indicated a good testosterone response. The karyotype analysis revealed no abnormalities. All required analyses and findings, including normo-osmium testing, indicated an idiopathic form of hypogonadotropic hypogonadism with consequent infertility and SD. Considering the adequate response in the stimulation tests, the induction of spermatogenesis was initiated with human chorionic gonadotropins (hCG), and Tadalafil was introduced for SD management. One month after the initiation of treatment, check-up findings were favorable (T 24.2 nmol/l). Anastrozole, an aromatase inhibitor, was then added to the treatment regimen. When the T level reached 20 nmol/l, Gonal-f (follitropin alfa) was introduced, resulting in an excellent response to treatment. Five months after treatment initiation, hormonal findings were satisfactory, and semen analysis showed significant improvement.
Conclusion: Timely replacement therapy with gonadotropin analogues in HH men with azoospermia and infertility is effective for stimulating spermatogenesis, improving fertility outcomes, fostering the development of secondary sexual characteristics, and enhancing sexual function.
Volume 102
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Endocrine Abstracts
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