Successful fertility treatment with gonadotrophin therapy for male hypogonadotrophic hypogonadism

Summary

Gonadotrophin therapy with human chorionic gonadotrophin and recombinant FSH is indicated for use in men with reduced spermatogenesis due to hypogonadotrophic hypogonadism (HH). Patients require regular monitoring for side effects and desired response to treatment. We present a man with HH, azoospermia and a history of previous anabolic steroid usage who had undergone gonadotrophin therapy, had subsequently achieved conception and has now fathered a child.

Learning points

• In total, 15% of couples do not achieve pregnancy within 1 year and seek medical treatment for infertility: male factors contribute to 50% of these.

• The evaluation of male infertility should include a full history and examination, an endocrine profile and a quality-controlled semen analysis.

• HH with defective spermatogenesis is an important cause of male infertility in a small percentage of cases.

• Gonadotrophin therapy requires regular monitoring for side effects and desired response to treatment.

• Any sustained rise in prostate specific antigen levels should prompt urological assessment for possible prostate biopsy.

• A multidisciplinary approach is required for gonadotrophin therapy, especially if assisted fertilisation techniques are required once, spermatogenesis is achieved.