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Testosterone Replacement, Low T, HCG, & Beyond
Clomid for PCT, fertility or low T
Recombinant Human FSH Treatment Outcomes in Five Boys With Severe Congenital Hypogonadotropic Hypogonadism
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<blockquote data-quote="madman" data-source="post: 130842" data-attributes="member: 13851"><p><strong><span style="color: rgb(184, 49, 47)">Context:</span></strong> Recombinant human FSH (r-hFSH), given to prepubertal boys with hypogonadotropic hypogonadism (HH), may induce Sertoli cell proliferation and thereby increase sperm-producing capacity later in life.</p><p></p><p></p><p><strong><span style="color: rgb(184, 49, 47)">Objective:</span></strong> To evaluate the effects of r-hFSH, human chorionic gonadotropin (hCG), and testosterone (T) in such patients.</p><p></p><p></p><p><strong><span style="color: rgb(184, 49, 47)">Design and Setting:</span></strong> Retrospective review in three tertiary centers in Finland between 2006 and 2016.</p><p></p><p></p><p><strong><span style="color: rgb(184, 49, 47)">Patients: </span></strong>Five boys: ANOS1 mutation in two, homozygous PROKR2 mutation in one, FGFR1 mutation in one, and homozygous GNRHR mutation in one. Prepubertal testicular volume (TV) varied between 0.3 and 2.3 mL; three boys had micropenis, three had undergone orchidopexy.</p><p></p><p></p><p><strong><span style="color: rgb(184, 49, 47)">Interventions:</span></strong> Two boys received r-hFSH (6 to 7 months) followed by r-hFSH plus hCG (33 to 34 months); one received T (6 months), then r-hFSH plus T (29 months) followed by hCG (25 months); two received T (3 months) followed by r-hFSH (7 months) or r-hFSH plus T (8 months).</p><p></p><p></p><p><strong><span style="color: rgb(184, 49, 47)">Main Outcome Measures:</span></strong> TV, inhibin B, anti-M¨ullerian hormone, T, puberty, sperm count.</p><p></p><p></p><p><strong><span style="color: rgb(184, 49, 47)">Results:</span></strong> r-hFSH doubled TV (from a mean +/- SD of 0.9 +/- 0.9 mL to 1.9 +/- 1.7 mL; P < 0.05) and increased serum inhibin B (from 15 +/- 5 ng/L to 85 +/- 40 ng/L; P < 0.05). hCG further increased TV (from 2.1 +/- 2.3 mL to 8.6 +/- 1.7 mL). Two boys with initially extremely small testis size (0.3 mL) developed sperm (maximal sperm count range, 2.8 to 13.8 million/mL), which was cryopreserved.</p><p></p><p></p><p><strong><span style="color: rgb(184, 49, 47)">Conclusions:</span></strong> Spermatogenesis can be induced with gonadotropins even in boys with HH who have extremely small testes, and despite low-dose T treatment given in early puberty. Induction of puberty with gonadotropins allows preservation of fertility.</p></blockquote><p></p>
[QUOTE="madman, post: 130842, member: 13851"] [B][COLOR=rgb(184, 49, 47)]Context:[/COLOR][/B] Recombinant human FSH (r-hFSH), given to prepubertal boys with hypogonadotropic hypogonadism (HH), may induce Sertoli cell proliferation and thereby increase sperm-producing capacity later in life. [B][COLOR=rgb(184, 49, 47)]Objective:[/COLOR][/B] To evaluate the effects of r-hFSH, human chorionic gonadotropin (hCG), and testosterone (T) in such patients. [B][COLOR=rgb(184, 49, 47)]Design and Setting:[/COLOR][/B] Retrospective review in three tertiary centers in Finland between 2006 and 2016. [B][COLOR=rgb(184, 49, 47)]Patients: [/COLOR][/B]Five boys: ANOS1 mutation in two, homozygous PROKR2 mutation in one, FGFR1 mutation in one, and homozygous GNRHR mutation in one. Prepubertal testicular volume (TV) varied between 0.3 and 2.3 mL; three boys had micropenis, three had undergone orchidopexy. [B][COLOR=rgb(184, 49, 47)]Interventions:[/COLOR][/B] Two boys received r-hFSH (6 to 7 months) followed by r-hFSH plus hCG (33 to 34 months); one received T (6 months), then r-hFSH plus T (29 months) followed by hCG (25 months); two received T (3 months) followed by r-hFSH (7 months) or r-hFSH plus T (8 months). [B][COLOR=rgb(184, 49, 47)]Main Outcome Measures:[/COLOR][/B] TV, inhibin B, anti-M¨ullerian hormone, T, puberty, sperm count. [B][COLOR=rgb(184, 49, 47)]Results:[/COLOR][/B] r-hFSH doubled TV (from a mean +/- SD of 0.9 +/- 0.9 mL to 1.9 +/- 1.7 mL; P < 0.05) and increased serum inhibin B (from 15 +/- 5 ng/L to 85 +/- 40 ng/L; P < 0.05). hCG further increased TV (from 2.1 +/- 2.3 mL to 8.6 +/- 1.7 mL). Two boys with initially extremely small testis size (0.3 mL) developed sperm (maximal sperm count range, 2.8 to 13.8 million/mL), which was cryopreserved. [B][COLOR=rgb(184, 49, 47)]Conclusions:[/COLOR][/B] Spermatogenesis can be induced with gonadotropins even in boys with HH who have extremely small testes, and despite low-dose T treatment given in early puberty. Induction of puberty with gonadotropins allows preservation of fertility. [/QUOTE]
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Testosterone Replacement, Low T, HCG, & Beyond
Clomid for PCT, fertility or low T
Recombinant Human FSH Treatment Outcomes in Five Boys With Severe Congenital Hypogonadotropic Hypogonadism
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