Hypergonadotropic Hypogonadism: Management of Infertility

Kalkanli A., Akdere H., Cevik G., Salabas E., Cilesiz N. C., Kadioglu A.

CURRENT PHARMACEUTICAL DESIGN, vol.27, no.24, pp.2790-2795, 2021 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Review
  • Volume: 27 Issue: 24
  • Publication Date: 2021
  • Doi Number: 10.2174/1381612826666201102110456
  • Journal Name: CURRENT PHARMACEUTICAL DESIGN
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, BIOSIS, Biotechnology Research Abstracts, CAB Abstracts, Chemical Abstracts Core, EMBASE, MEDLINE, Veterinary Science Database
  • Page Numbers: pp.2790-2795
  • Keywords: Hypergonadotropic hypogonadism, male infertility, empirical medical treatment, gonadotropins, aromatase inhibitors, selective estrogen receptor modulators, TESTICULAR SPERM EXTRACTION, FOLLICLE-STIMULATING-HORMONE, HUMAN CHORIONIC-GONADOTROPIN, IDIOPATHIC MALE-INFERTILITY, KLINEFELTER SYNDROME, NONOBSTRUCTIVE AZOOSPERMIA, CLOMIPHENE CITRATE, VARICOCELE REPAIR, COMPENSATED HYPOGONADISM, AROMATASE INHIBITORS
  • Istanbul University Affiliated: Yes

Abstract

Background: Medical treatments are used either alone or in combination with assisted reproductive techniques for the treatment of infertile patients with hypergonadotropic hypogonadism. A wide range of treatment options such as gonadotropins, aromatase inhibitors (AIs), selective estrogen receptor modulators (SERMs) and their combination are available as options. Objective: The aim of this review was to evaluate treatment options for infertile men with hypergonadotropic hypogonadism. Methods: A literature search of MEDLINE (1980-2019) was conducted using the terms 'hypogonadism', 'male infertility', 'gonadotropins', 'SERMs' and 'AIs'. Pathologies leading to hypergonadotropic hypogonadism and treatment modalities such as gonadotropins, SERMs, AIs and surgical treatment were discussed. Results: FSH increases spontaneous pregnancy rates but the level of evidence was proven to be low for live birth rates. AIs are valid treatment options for patients with low T/E2 ratio as they significantly increase sperm concentrations. SERMs are recommended for infertile males with a sperm concentration between 10-20 million. Varicocele was reported to increase testosterone levels of hypogonadic infertile males. Conclusion: Medical treatment modalities such as gonadotropins, SERMs, AIs and a combination of these therapies has been showed to have some effect in improvement of fertility but is not mainstream of the treatment.