Spermatogenesis induction successful with gonadotropin treatment

Gonadotropin treatment helps promote sperm production, especially in most men with pathological gonadotropin deficiency, according to the results of a systematic review and meta-analysis.

Researchers searched multiple online databases for studies wherein outcomes related to male reproductive function following gonadotropin treatment were reported. A total of 41 studies, which involve 1,673 patients with a mean age of 25 years, met the eligibility criteria and were included.

Pooled data showed that a median of 18 months of gonadotropin treatment resulted in an average sperm concentration of 11.6 M/mL of ejaculate (95 percent confidence interval [CI], 8.4–14.9). Specifically, 15 percent of patients achieved sperm concentrations >20 M/mL, 24 percent achieved >10 M/ml, 36 percent achieved >5 M/ml, 55 percent achieved >1 M/ml, and 78 percent achieved >0 M/ml.

Compared with human chorionic gonadotropin (hCG) monotherapy, combination treatment with hCG plus follicle-stimulating hormone (FSH) was associated with significantly greater mean sperm output and percentage of patients achieving all sperm thresholds. Mean sperm output, when compared by diagnosis, was substantially lower in patients with congenital hypogonadotrophic hypogonadism (CHH) than in those with hypopituitarism or mixed patient cohorts that did not differentiate between CHH and hypopituitarism.

Treatment-related increases in testosterone and testicular volume did not significantly differ between hCG-treated and hCG–FSH-treated patients. However, testicular volume increased with a lower magnitude in patients with CHH than in those with hypopituitarism.