madman
Super Moderator
* Use of hCG+TRT suppressed LH and FSH (p<0.05), whereas CC+TRT was associated with reduction in FSH only (p=0.02). However, at 6 months, CC monotherapy was associated with significant increases in LH and FSH (p<0.001). As expected, all three treatments were associated with substantial increases in both total and free testosterone within 6 months with rapid attainment of physiological levels (ranging from 23.58nmol/L to 26.52nmol/L). Similar magnitudes of increases in QADAM scores were observed across the three approaches (from 7.86 points to 9.50 points, all p<0.001).
Clift, A1; Johnson, H1; Huang, D1
1 - Menwell Ltd
Introduction
Men of reproductive age with testosterone deficiency (TD) considering their fertility may be candidates for treatment strategies including testosterone replacement (TRT) with adjunct human chorionic gonadotropin (hCG), adjunct clomiphene citrate (CC), or CC monotherapy. There is limited evidence on the longitudinal impacts of these strategies on pituitary axis function and their relative effectiveness.
Objective
To analyse trends in luteinizing hormone (LH), follicle-stimulating hormone (FSH), total and free testosterone levels during 6 months of treatment with hCG+TRT, CC+TRT and CC monotherapy.
Methods
We conducted a retrospective cohort study of men undergoing treatment for TD with the aforementioned 3 strategies. Mixed effects models characterised changes in average measurements between baseline and 6 months of treatment with 95% confidence intervals.
Results
A total of 6,999 adult men were included: 6,364 men (91%) were prescribed hCG+TRT, 552 (8%) were prescribed CC+TRT, and 83 (1%) were prescribed CC monotherapy. The median ages of men prescribed hCG + TRT, CC + TRT, and CC monotherapy were 42, 44, and 36, respectively. Use of hCG+TRT suppressed LH and FSH (p<0.05), whereas CC+TRT was associated with reduction in FSH only (p=0.02). However, at 6 months, CC monotherapy was associated with significant increases in LH and FSH (p<0.001). As expected, all three treatments were associated with substantial increases in both total and free testosterone within 6 months with rapid attainment of physiological levels (ranging from 23.58nmol/L to 26.52nmol/L). Similar magnitudes of increases in QADAM scores were observed across the three approaches (from 7.86 points to 9.50 points, all p<0.001).
Conclusions
This longitudinal study characterised distinct patterns in the natural history of pituitary hormone levels across three TD treatment options relevant to men seeking to preserve fertility. Future studies should prospectively correlate these longitudinal hormonal trends with semen analysis parameters and other fertility outcomes to permit personalised treatment selection.
Clift, A1; Johnson, H1; Huang, D1
1 - Menwell Ltd
Introduction
Men of reproductive age with testosterone deficiency (TD) considering their fertility may be candidates for treatment strategies including testosterone replacement (TRT) with adjunct human chorionic gonadotropin (hCG), adjunct clomiphene citrate (CC), or CC monotherapy. There is limited evidence on the longitudinal impacts of these strategies on pituitary axis function and their relative effectiveness.
Objective
To analyse trends in luteinizing hormone (LH), follicle-stimulating hormone (FSH), total and free testosterone levels during 6 months of treatment with hCG+TRT, CC+TRT and CC monotherapy.
Methods
We conducted a retrospective cohort study of men undergoing treatment for TD with the aforementioned 3 strategies. Mixed effects models characterised changes in average measurements between baseline and 6 months of treatment with 95% confidence intervals.
Results
A total of 6,999 adult men were included: 6,364 men (91%) were prescribed hCG+TRT, 552 (8%) were prescribed CC+TRT, and 83 (1%) were prescribed CC monotherapy. The median ages of men prescribed hCG + TRT, CC + TRT, and CC monotherapy were 42, 44, and 36, respectively. Use of hCG+TRT suppressed LH and FSH (p<0.05), whereas CC+TRT was associated with reduction in FSH only (p=0.02). However, at 6 months, CC monotherapy was associated with significant increases in LH and FSH (p<0.001). As expected, all three treatments were associated with substantial increases in both total and free testosterone within 6 months with rapid attainment of physiological levels (ranging from 23.58nmol/L to 26.52nmol/L). Similar magnitudes of increases in QADAM scores were observed across the three approaches (from 7.86 points to 9.50 points, all p<0.001).
Conclusions
This longitudinal study characterised distinct patterns in the natural history of pituitary hormone levels across three TD treatment options relevant to men seeking to preserve fertility. Future studies should prospectively correlate these longitudinal hormonal trends with semen analysis parameters and other fertility outcomes to permit personalised treatment selection.
