madman
Super Moderator
Author Block: BIONA DEVI KONSAM, DM1, Rama Walia2, Sanjay Bhadada, Professor & Head (DM Endocrinology)2, Pinaki Dutta, DM2. 1JNIMS, Imphal, IMPHAL EAST, India, 2PGIMER, Chandigarh, Chandigarh, India.
Disclosure Block: B.D. Konsam: None. R. Walia: None. S. Bhadada: None. P. Dutta: None.
Background
The study evaluated whether triple therapy with human chorionic gonadotropin (hCG), follicle-stimulating hormone (FSH) and testosterone (T) reduced the required hCG dose in the treatment of congenital hypogonadotropic hypogonadism(CHH), improving treatment effectiveness and cost-efficiency.
Methods
This study was an open-label randomized controlled trial (1:1:1) conducted on CHH.Group A received triple therapy,Group B received hCG and FSH, and Group C received hCG followed by FSH.Initial doses included hCG 2000 IU twice weekly,FSH 75 IU thrice weekly, and testosterone 100 mg every two weeks.In Group A, hCG was adjusted to achieve an AMH level of 7.4 ng/ml, while Groups B and C aimed for testosterone normalization.The primary objective was to compare hCG and FSH doses required for spermatogenesis induction and the time to spermatogenesis.
Results
Forty-five CHH, evenly distributed among 3 groups with mean age of 25.8±6.14 years, were enrolled. Spermatogenesis was achieved in 84.6% of group A participants while in groups B and C, rates were 69.2% and 75% respectively(p=0.648).The median hCG dose at spermatogenesis was 7500IU/week in group A and 9000IU/week in groups B and C(p=0.016). The time to achieve spermatogenesis was comparable (Groups A and B-12months and C-15months,p=0.345).The Group A participants achieved AMH of 3.5(2.31-5.38)ng/ml comparable to the other groups(p=0.962).The factors that indicated spermatogenesis were USGmTV cut-off of 1.97 ml(sensitivity-86.2%,specificity-62.5%), hCG dose of 9000 IU/week(sensitivity-79.3%,specificity-87.5%) and Inh B cut-off of 66.8 pg/ml(sensitivity-92.6%,specificity-100%).
Conclusions
This study indicated that triple therapy is a reasonable and novel way of managing CHH, with AMH and Inh B providing an effective means of monitoring.
Disclosure Block: B.D. Konsam: None. R. Walia: None. S. Bhadada: None. P. Dutta: None.
Background
The study evaluated whether triple therapy with human chorionic gonadotropin (hCG), follicle-stimulating hormone (FSH) and testosterone (T) reduced the required hCG dose in the treatment of congenital hypogonadotropic hypogonadism(CHH), improving treatment effectiveness and cost-efficiency.
Methods
This study was an open-label randomized controlled trial (1:1:1) conducted on CHH.Group A received triple therapy,Group B received hCG and FSH, and Group C received hCG followed by FSH.Initial doses included hCG 2000 IU twice weekly,FSH 75 IU thrice weekly, and testosterone 100 mg every two weeks.In Group A, hCG was adjusted to achieve an AMH level of 7.4 ng/ml, while Groups B and C aimed for testosterone normalization.The primary objective was to compare hCG and FSH doses required for spermatogenesis induction and the time to spermatogenesis.
Results
Forty-five CHH, evenly distributed among 3 groups with mean age of 25.8±6.14 years, were enrolled. Spermatogenesis was achieved in 84.6% of group A participants while in groups B and C, rates were 69.2% and 75% respectively(p=0.648).The median hCG dose at spermatogenesis was 7500IU/week in group A and 9000IU/week in groups B and C(p=0.016). The time to achieve spermatogenesis was comparable (Groups A and B-12months and C-15months,p=0.345).The Group A participants achieved AMH of 3.5(2.31-5.38)ng/ml comparable to the other groups(p=0.962).The factors that indicated spermatogenesis were USGmTV cut-off of 1.97 ml(sensitivity-86.2%,specificity-62.5%), hCG dose of 9000 IU/week(sensitivity-79.3%,specificity-87.5%) and Inh B cut-off of 66.8 pg/ml(sensitivity-92.6%,specificity-100%).
Conclusions
This study indicated that triple therapy is a reasonable and novel way of managing CHH, with AMH and Inh B providing an effective means of monitoring.
