madman
Super Moderator
Efficacy of follitropin-alpha versus human menopausal gonadotropin for male patients with congenital hypogonadotropic hypogonadism
ABSTRACT
Objective: To compare human menopausal gonadotropin (hMG) and recombinant follicle-stimulating hormone (rFSH) with respect to successful spermatogenesis and pregnancy outcomes in patients with congenital hypogonadotropic hypogonadism (CHH).
Material and methods: This retrospective study included a total of 112 male patients with CHH. Of these, 70 were to receive treatment with hMG and 42 with rFSH following the hCG administration.
Results: The average age at diagnosis was 27.9 (range, 15–51) years. The baseline luteinizing hormone (LH), follicle-stimulating hormone (FSH), and testosterone levels were 0.53±0.77 IU/L, 0.63±0.61 IU/L, and 1.10±1.90 ng/dL, respectively. Following the combined hormonal treatment, 85.7% (96/112) of patients had sperm detected in ejaculate samples. In the hMG group, the mean baseline of a testicular size was slightly lower than in the rFSH group (5.0±3.5 mL and 5.3±3.9 mL), whereas these differences were not statistically significant (p=0.364). The mean baseline age, level of FSH, LH, and testosterone also showed no significant difference between the two treatment options. The rate of successful spermatogenesis was similar (85.7%) in both groups, while the pregnancy rates of patients who underwent hMG and rFSH treatments were 38.6% (n=27) and 51.2% (n=21); however, these differences were not statistically significant (p=0.314). No patients developed severe effects during the treatment period.
Conclusion: Successful spermatogenesis and pregnancy rates with hMG and rFSH are similar
In conclusion, the current medical approach for male patients with HH provides spermatogenesis successful enough for the achievement of pregnancy. The patients can achieve successful spermatogenesis via either rFSH or hMG, and there is no difference in outcomes between the two treatment regimes. However, using urinary FSH may be a more cost-effective treatment option than the recombinant form. Randomized controlled trials with greater patient numbers are required for future studies.
ABSTRACT
Objective: To compare human menopausal gonadotropin (hMG) and recombinant follicle-stimulating hormone (rFSH) with respect to successful spermatogenesis and pregnancy outcomes in patients with congenital hypogonadotropic hypogonadism (CHH).
Material and methods: This retrospective study included a total of 112 male patients with CHH. Of these, 70 were to receive treatment with hMG and 42 with rFSH following the hCG administration.
Results: The average age at diagnosis was 27.9 (range, 15–51) years. The baseline luteinizing hormone (LH), follicle-stimulating hormone (FSH), and testosterone levels were 0.53±0.77 IU/L, 0.63±0.61 IU/L, and 1.10±1.90 ng/dL, respectively. Following the combined hormonal treatment, 85.7% (96/112) of patients had sperm detected in ejaculate samples. In the hMG group, the mean baseline of a testicular size was slightly lower than in the rFSH group (5.0±3.5 mL and 5.3±3.9 mL), whereas these differences were not statistically significant (p=0.364). The mean baseline age, level of FSH, LH, and testosterone also showed no significant difference between the two treatment options. The rate of successful spermatogenesis was similar (85.7%) in both groups, while the pregnancy rates of patients who underwent hMG and rFSH treatments were 38.6% (n=27) and 51.2% (n=21); however, these differences were not statistically significant (p=0.314). No patients developed severe effects during the treatment period.
Conclusion: Successful spermatogenesis and pregnancy rates with hMG and rFSH are similar
In conclusion, the current medical approach for male patients with HH provides spermatogenesis successful enough for the achievement of pregnancy. The patients can achieve successful spermatogenesis via either rFSH or hMG, and there is no difference in outcomes between the two treatment regimes. However, using urinary FSH may be a more cost-effective treatment option than the recombinant form. Randomized controlled trials with greater patient numbers are required for future studies.
