Fertility and Puberty in Males with Congenital Hypogonadotropic Hypogonadism

[madman]

 

[madman]

Summary of this Presentation

 

[madman]

Male HPG axis:

- Homeostatic and Environmental inputs
- Endocrine and Paracrine actions of T

 

[madman]

Kallmann's age 25

Greek bronze found by diver in the Bay of Riace, Italy, 1972

How to get from A to B (Testosterone)

 

[madman]

Human spermatogenesis requires both FSH and µmolar locally-secreted intratesticular paracrine T

- 100X serum concentration is normal

- 10-20X serum will do and is achievable with hCG 500 iU 2-3X/week


Can't be sustained by µmolar nmolar circulating endocrine T

 

[madman]

Sexual Dimorphism in Gametogenesis

Triphasic Maturation of Testes

 

[madman]

Cells of the testis

Exogenous androgens in the system (exogenous T)

- shutdown of LH/FSH secretion

- even though we increase levels of testosterone in circulation we actually cause levels in the testes to collapse and also spermatogenesis likewise collapses

 

[madman]

Classification of Male Hypogonadism

 

[madman]

Differential diagnosis of male 2° (Central or Hypogonadotropic) Hypogonadism

 

[madman]

DON'T GIVE THEM ANY TESTOSTERONE ESPECIALLY IF THEY WANT FERTILITY

STOPPING T USUALLY RESTORES FERTILITY

 

[madman]

Congenital Hypogonadotropic Hypogonadism

 

[madman]

Spermatogenesis-induction in HH 101

 

[madman]

Gonadotropin therapy for Spermatogenesis

hCG (LH half life is far too short), acting on Leydig cell LHCGR

 

[madman]

How likely is GN-sperm-induction to succeed in Central Hypogonadism?

 

[madman]

Improving Spermatogenesis Outcomes in CHH

 

[madman]

Thread 'Fertility maintenance or restoration in men before, during, and after TRT or AAS'

Sep 25, 2022

Fertility Preservation in Hypogonadal Men (2018)
Robert J. Carrasquillo and Ranjith Ramasamy


Introduction

Testicular failure is defined as the impairment or loss of both the endocrine functions of the testis (production of testosterone, or T) and exocrine function (production of spermatozoa). Testicular failure can result from the pathology of the testis itself or disorder at any point in the hypothalamic-pituitary-gonadal axis. Primary testicular failure is characterized by normal/low T in the presence of the elevated follicle-stimulating hormone...

• madman
• fertility/spermatogenesis; tth/aas; hypogonadism
• Replies: 34
• Forum: hCG, Clomid & Others for Fertility, PCT or Low T

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