ExcelMale
Menu
Home
What's new
Latest activity
Forums
New posts
Search forums
What's new
New posts
Latest activity
Videos
Lab Tests
Doctor Finder
Buy Books
About Us
Men’s Health Coaching
Log in
Register
What's new
Search
Search
Search titles only
By:
New posts
Search forums
Menu
Log in
Register
Navigation
Install the app
Install
More options
Contact us
Close Menu
Forums
Testosterone Replacement, Low T, HCG, & Beyond
Clomid for PCT, fertility or low T
FSH therapy for idiopathic male infertility: four schemes are better than one
JavaScript is disabled. For a better experience, please enable JavaScript in your browser before proceeding.
You are using an out of date browser. It may not display this or other websites correctly.
You should upgrade or use an
alternative browser
.
Reply to thread
Message
<blockquote data-quote="madman" data-source="post: 270541" data-attributes="member: 13851"><p><strong>EAU Guidelines on Sexual and Reproductive Health (2023)</strong></p><p><strong></strong></p><p><strong></strong></p><p><strong>11.5.3 Hormonal therapy</strong></p><p><strong></strong></p><p><strong>11.5.3.1 Gonadotrophins</strong></p><p></p><p><em><strong>Follicle Stimulating Hormone is primarily involved in the initiation of spermatogenesis and testicular growth during puberty. The role of FSH post-puberty has not been clearly defined. </strong>Luteinizing hormone stimulates testosterone production in the testes, but due to its short half-life, it is not suitable for clinical use. Human chorionic Gonadotrophin acts in a similar manner to LH and can be used pharmacologically to stimulate testosterone release in men with failure of their hypothalamic-pituitary-gonadal axis. Human Chorionic Gonadotrophin can adequately stimulate spermatogenesis in men who have developed hypopituitarism after normal puberty. Therefore, the treatment of men with secondary hypogonadism depends on whether or not they developed hypothalamic-pituitary failure before or after puberty [5]</em></p><p></p><p></p><p></p><p></p><p><strong>11.5.3.2.2 Post-Pubertal Onset Secondary</strong></p><p></p><p><em>If secondary hypogonadism develops after puberty, hCG alone is usually required first to stimulate spermatogenesis. Doses of subcutaneous hCG required may be lower than those used in individuals with pre-pubertal onset; therefore, a starting dose of 250 IU twice weekly is suggested, and if normal testosterone levels are reached, hCG doses may be increased up to 2,000 IU twice weekly as for pre-pubertal onset. Again, semen analysis should be performed every 3 months to assess response, unless conception has taken place.<strong> <u>If there is a failure of stimulation of spermatogenesis, then FSH can be added (75 IU three times per week, increasing to 150 IU three times per week if indicated)</u>. <u>Similarly, combination therapy with FSH and hCG can be administered from the beginning of treatment, promoting better outcomes in men with HH [141]</u>. No difference in outcomes was observed when urinary-derived, highly purified FSH was compared to recombinant FSH [141].</strong></em></p><p><em><strong></strong></em></p><p><em><strong>Greater baseline testicular volume is a good prognostic indicator for response to gonadotrophin treatment[2138].</strong> Data had suggested that previous testosterone therapy can have a negative impact on gonadotropin treatment outcomes in men with HH [2138]. <strong>However, this observation has been subsequently refuted by a meta-analysis that did not confirm a real negative role of testosterone therapy in terms of future fertility in this specific setting [141].</strong></em></p><p><em></em></p><p><em>In the presence of hyperprolactinemia, causing suppression of gonadotrophins resulting in sub-fertility the treatment independent of etiology (including a pituitary adenoma) is dopamine agonist therapy or withdrawal of the drug that causes the condition. Dopamine agonists used include bromocriptine, cabergoline andquinagolide</em></p><p></p><p></p><p></p><p></p><p><strong>11.5.3.3 Primary Hypogonadism</strong></p><p></p><p><em><strong>There is no substantial evidence that gonadotrophin therapy has any beneficial effect in the presence of classical testicular failure. Likewise, there is no data to support the use of other hormonal treatments (including SERMs or AIs) in the case of primary hypogonadism to improve spermatogenesis [105, 2139].</strong></em></p><p></p><p></p><p></p><p></p><p>[URL unfurl="true"]https://www.excelmale.com/forum/threads/fsh-and-hcg-dual-therapy-may-result-in-the-more-rapid-recovery-of-sperm-to-the-ejaculate.22230/[/URL]</p></blockquote><p></p>
[QUOTE="madman, post: 270541, member: 13851"] [B]EAU Guidelines on Sexual and Reproductive Health (2023) 11.5.3 Hormonal therapy 11.5.3.1 Gonadotrophins[/B] [I][B]Follicle Stimulating Hormone is primarily involved in the initiation of spermatogenesis and testicular growth during puberty. The role of FSH post-puberty has not been clearly defined. [/B]Luteinizing hormone stimulates testosterone production in the testes, but due to its short half-life, it is not suitable for clinical use. Human chorionic Gonadotrophin acts in a similar manner to LH and can be used pharmacologically to stimulate testosterone release in men with failure of their hypothalamic-pituitary-gonadal axis. Human Chorionic Gonadotrophin can adequately stimulate spermatogenesis in men who have developed hypopituitarism after normal puberty. Therefore, the treatment of men with secondary hypogonadism depends on whether or not they developed hypothalamic-pituitary failure before or after puberty [5][/I] [B]11.5.3.2.2 Post-Pubertal Onset Secondary[/B] [I]If secondary hypogonadism develops after puberty, hCG alone is usually required first to stimulate spermatogenesis. Doses of subcutaneous hCG required may be lower than those used in individuals with pre-pubertal onset; therefore, a starting dose of 250 IU twice weekly is suggested, and if normal testosterone levels are reached, hCG doses may be increased up to 2,000 IU twice weekly as for pre-pubertal onset. Again, semen analysis should be performed every 3 months to assess response, unless conception has taken place.[B] [U]If there is a failure of stimulation of spermatogenesis, then FSH can be added (75 IU three times per week, increasing to 150 IU three times per week if indicated)[/U]. [U]Similarly, combination therapy with FSH and hCG can be administered from the beginning of treatment, promoting better outcomes in men with HH [141][/U]. No difference in outcomes was observed when urinary-derived, highly purified FSH was compared to recombinant FSH [141]. Greater baseline testicular volume is a good prognostic indicator for response to gonadotrophin treatment[2138].[/B] Data had suggested that previous testosterone therapy can have a negative impact on gonadotropin treatment outcomes in men with HH [2138]. [B]However, this observation has been subsequently refuted by a meta-analysis that did not confirm a real negative role of testosterone therapy in terms of future fertility in this specific setting [141].[/B] In the presence of hyperprolactinemia, causing suppression of gonadotrophins resulting in sub-fertility the treatment independent of etiology (including a pituitary adenoma) is dopamine agonist therapy or withdrawal of the drug that causes the condition. Dopamine agonists used include bromocriptine, cabergoline andquinagolide[/I] [B]11.5.3.3 Primary Hypogonadism[/B] [I][B]There is no substantial evidence that gonadotrophin therapy has any beneficial effect in the presence of classical testicular failure. Likewise, there is no data to support the use of other hormonal treatments (including SERMs or AIs) in the case of primary hypogonadism to improve spermatogenesis [105, 2139].[/B][/I] [URL unfurl="true"]https://www.excelmale.com/forum/threads/fsh-and-hcg-dual-therapy-may-result-in-the-more-rapid-recovery-of-sperm-to-the-ejaculate.22230/[/URL] [/QUOTE]
Insert quotes…
Verification
Post reply
Share this page
Facebook
Twitter
Reddit
Pinterest
Tumblr
WhatsApp
Email
Share
Link
Sponsors
Forums
Testosterone Replacement, Low T, HCG, & Beyond
Clomid for PCT, fertility or low T
FSH therapy for idiopathic male infertility: four schemes are better than one
This site uses cookies to help personalise content, tailor your experience and to keep you logged in if you register.
By continuing to use this site, you are consenting to our use of cookies.
Accept
Learn more…
Top