Congenital combined pituitary hormone deficiency patients have better responses to gonadotrophin-induced spermatogenesis than idiopathic hypogonadotropic hypogonadism patients.

摘要: STUDY QUESTION Do patients with congenital combined pituitary hormone deficiency (CCPHD) have different responses to gonadotrophin-induced spermatogenesis compared those idiopathic hypogonadotropic hypogonadism (IHH)? SUMMARY ANSWER CCPHD a better response gonadotrophin therapy than IHH patients. WHAT IS KNOWN ALREADY Gonadotrophins are effective in inducing hypogonadism. DESIGN, SIZE AND DURATION This retrospective cohort study included 75 patients, 53 of whom had and 22 CCPHD. They were diagnosed, treated followed up between January 2008 December 2013. PARTICIPANTS/MATERIALS, SETTING METHODS Combined therapy, consisting human chorionic menopausal gonadotrophin, was administered for 24 months. The success rate (≥1 sperm ejaculate), serum total testosterone level, testicle size concentration during the treatment, as well first time detected ejaculate, two diagnostic groups. All Peking Union Medical College Hospital. MAIN RESULTS THE ROLE OF CHANCE Spermatogenesis successfully induced 85% 100% after 24-month treatment (P = 0.03). In comparison IHH, larger mean sizes at 6, 12, 18 months (all P < 0.05). initial appearance group (n 45) 22) 13.2 ± 5.9 versus 10.4 3.8 0.045). Generally, higher counts [median (quartiles)] but difference only statistically significant 12 3.3 (1.8, 12.0) 1.0 (0.0, 4.6) million/ml, 0.001. There level [mean (SD)] (676 245 555 209 ng/dl, 0.035). LIMITATIONS, REASONS FOR CAUTION First, inherent nature designed main shortcoming. Secondly, pathological gene mutations should be further investigated. Clarification underlying mechanisms cryptorchidism mutated genes may provide more information divergent therapeutic Only minority actively seeking children so about fertility is limited. WIDER IMPLICATIONS FINDINGS lower incidence reflecting multiple defects on levels reproduction axis IHH. Furthermore, growth not indispensable FUNDING/COMPETING INTERESTS supported by Natural Science Foundation China (No: 81100416). None authors has any conflicts interest declare.