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
How to Improve Sperm Quality, LH, FSH and Testosterone in Infertile Men
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: 197020" data-attributes="member: 13851"><p>[URL unfurl="true"]https://www.excelmale.com/forum/threads/gonadotropin-treatment-for-the-male-hh.22606/[/URL]</p><p></p><p></p><p><strong>3.7. Routes of Administration </strong></p><p></p><p>Gonadotropins can be administered either subcutaneously or intramuscularly. The subcutaneous route of administration is as effective as the intramuscular one but significantly increases patient compliance.<strong><em> Some HH patients can restore sperm production and fertility even using hCG alone, with a standard dosage of 500 - 2500 IU injection 2 to 3 times weekly [23]. The dose of hCG can be reduced over time as the testicular size eventually increases.</em> <em><u>However, when sperm concentration in the ejaculate is lower than 10 million/ml or once there is a plateau in the response to hCG, which typically occurs at 6 months, FSH therapy (in one of the three forms described above) should be added at a dose of 75 IU on alternate days</u>. <u>If sperm production and testicular growth remain suboptimal, the dose of FSH can be gradually increased up to 150 IU daily</u></em>. </strong><u><em><strong>A number of evidences have shown that adding FSH (any forms) to hCG was associated with a significantly better outcome as compared with hCG alone [24] (Fig. 2)</strong></em></u><em><strong>.</strong></em></p><p></p><p></p><p><strong>Fig. (2). Induction of spermatogenesis in males with post-pubertal onset hypogonadotropic hypogonadism</strong></p><p>[ATTACH=full]13175[/ATTACH]</p><p></p><p></p><p><strong><em>The use of this combined therapy for a period of 12-24 months induces testicular growth in almost all patients, spermatogenesis in approximately 80%, and pregnancy rates in the range of 50% [24,41,32,45].</em></strong></p><p><strong><em></em></strong></p><p><strong><em>Furthermore, it has also been shown that induction of spermatogenesis achieved by FSH plus hCG treatment in HH can be maintained qualitatively, but not quantitatively in most of the patients with hCG alone [46].</em></strong> Along this line, a sequential therapy with 3 months of treatment with FSH plus hCG alternated by hCG therapy alone for another 3 months has been proposed to reduce the relatively high costs of gonadotropin therapy [28]. However, it is still not known if this dosing regimen has the same high efficacy on the primary outcome i.e. clinical pregnancy rate.</p><p></p><p><strong><em>The dose and injection interval of FSH might be adapted on an individual basis to achieve the best treatment outcome. <u>As a whole, the testicular volume increase, the stimulation of spermatogenesis, the serum levels of FSH and testosterone achieved, and other factors can monitor the efficacy of the treatment</u>. </em></strong>Unfortunately, large randomized comparative studies with different FSH preparations, different doses, and different injection intervals are still missing in HH men [47,36].<strong><em> <u>Interestingly enough, a retrospective study suggested that lower weekly FSH doses are sufficient to stimulate spermatogenesis and allow induction of the desired pregnancy in the female partner</u> [36].</em></strong></p><p><strong><em></em></strong></p><p><strong><em>In terms of efficacy, a quite recent meta-analysis evaluating the available longitudinal studies dealing with the achievement of spermatogenesis after gonadotropin therapy in azoospermic HH individuals showed an overall successful outcome in 75% of patients, with a mean sperm concentration achieved of almost 6 million/mL [48]. <u>Better results were obtained in patients with a postpubertal onset of HH and in those with lower endogenous LH and FSH levels before initiating therapy</u>[48].</em></strong><em><strong>In an Australian study of 75 men with HH treated with gonadotropins, the median time for sperm to appear in the ejaculate was 7.1 months and for conception, it was approximately 28 months [32]. Similar data were reported in a compilation of clinical trial data from Asian, European, Australian and American patients [45]</strong>.</em></p></blockquote><p></p>
[QUOTE="madman, post: 197020, member: 13851"] [URL unfurl="true"]https://www.excelmale.com/forum/threads/gonadotropin-treatment-for-the-male-hh.22606/[/URL] [B]3.7. Routes of Administration [/B] Gonadotropins can be administered either subcutaneously or intramuscularly. The subcutaneous route of administration is as effective as the intramuscular one but significantly increases patient compliance.[B][I] Some HH patients can restore sperm production and fertility even using hCG alone, with a standard dosage of 500 - 2500 IU injection 2 to 3 times weekly [23]. The dose of hCG can be reduced over time as the testicular size eventually increases.[/I] [I][U]However, when sperm concentration in the ejaculate is lower than 10 million/ml or once there is a plateau in the response to hCG, which typically occurs at 6 months, FSH therapy (in one of the three forms described above) should be added at a dose of 75 IU on alternate days[/U]. [U]If sperm production and testicular growth remain suboptimal, the dose of FSH can be gradually increased up to 150 IU daily[/U][/I]. [/B][U][I][B]A number of evidences have shown that adding FSH (any forms) to hCG was associated with a significantly better outcome as compared with hCG alone [24] (Fig. 2)[/B][/I][/U][I][B].[/B][/I] [B]Fig. (2). Induction of spermatogenesis in males with post-pubertal onset hypogonadotropic hypogonadism[/B] [ATTACH type="full"]13175[/ATTACH] [B][I]The use of this combined therapy for a period of 12-24 months induces testicular growth in almost all patients, spermatogenesis in approximately 80%, and pregnancy rates in the range of 50% [24,41,32,45]. Furthermore, it has also been shown that induction of spermatogenesis achieved by FSH plus hCG treatment in HH can be maintained qualitatively, but not quantitatively in most of the patients with hCG alone [46].[/I][/B] Along this line, a sequential therapy with 3 months of treatment with FSH plus hCG alternated by hCG therapy alone for another 3 months has been proposed to reduce the relatively high costs of gonadotropin therapy [28]. However, it is still not known if this dosing regimen has the same high efficacy on the primary outcome i.e. clinical pregnancy rate. [B][I]The dose and injection interval of FSH might be adapted on an individual basis to achieve the best treatment outcome. [U]As a whole, the testicular volume increase, the stimulation of spermatogenesis, the serum levels of FSH and testosterone achieved, and other factors can monitor the efficacy of the treatment[/U]. [/I][/B]Unfortunately, large randomized comparative studies with different FSH preparations, different doses, and different injection intervals are still missing in HH men [47,36].[B][I] [U]Interestingly enough, a retrospective study suggested that lower weekly FSH doses are sufficient to stimulate spermatogenesis and allow induction of the desired pregnancy in the female partner[/U] [36]. In terms of efficacy, a quite recent meta-analysis evaluating the available longitudinal studies dealing with the achievement of spermatogenesis after gonadotropin therapy in azoospermic HH individuals showed an overall successful outcome in 75% of patients, with a mean sperm concentration achieved of almost 6 million/mL [48]. [U]Better results were obtained in patients with a postpubertal onset of HH and in those with lower endogenous LH and FSH levels before initiating therapy[/U][48].[/I][/B][I][B]In an Australian study of 75 men with HH treated with gonadotropins, the median time for sperm to appear in the ejaculate was 7.1 months and for conception, it was approximately 28 months [32]. Similar data were reported in a compilation of clinical trial data from Asian, European, Australian and American patients [45][/B].[/I] [/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
How to Improve Sperm Quality, LH, FSH and Testosterone in Infertile Men
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