EFFFECT OF PRIOR TESTOSTERONE THERAPY ON FUTURE TESTICULAR VOLUME & SPERMATOGENESIS IN MALE CONGENITAL HYPOGONADOTROPIC HYPOGONADISM IN A TERTIARY CARE CENTRE IN EASTERN INDIA

Dr Somnath Singh Raghuvanshi, Dr Animesh Maiti, Dr Anirban Sinha, Dr Asish Kumar Basu

Abstract


Gonadotropin induces masculinization and spermatogenesis in men with congenital hypogonadotropic hypogonadism (CHH) via testicular
androgen production .However, large cohort studies for the efficacy and reliable predictors of this therapy need to be conducted.
Aim: The aim of this real scenario was to investigate the efficacy of gonadotropin vs gonadotropin & testosterone treatment in a cohort of male
CHH patients and analyze putative predictors for successful spermatogenesis. In this study we included 7 CHH azoospermic patients without
puberty development treated between 2015 and 2018. All patients received combined human chorionic gonadotropin (HCG) and human
recombinant Follicular stimulating hormone(FSH) & out of 7 three patient received testosterone plus gonadotropin(TGT) , the testosterone therapy
was omitted at least 3 month before the gonadotropin therapy(GT) and were followed up for 3 monthly . Serum total testosterone level, testicular
volume , spermatogenesis, were recorded at each visit.
Results: The mean Age were 23 ± 2.48 & 25.3±1.45 in GT and TGT group respectively which has the p value of >0.05. After gonadotropin therapy,
testicular size was enlarged from 2.03±.20 to 5.93 ± 1.36 mL (P<0.0001) in GT & 8±1.6 ml (P0.0001) in TGT and the serum total testosterone was
elevated from 14.95±0.97 to 364±129 ng/dl/L (P<0.001) in GT &. 588±233 (P0.0001)ng/dl in TGT . There were no singnificant diffence in TV and
testosterone among T and TGT patients .
Spermatogenesis occurred in both group with a mean value of 0 (p 0.00001) , 12.5(p >0.05), 22.6 (p>0.05) million/ml at baseline , GT & TGT
groups respectively.
Conclusion : In this scenario the TGT therapy associated with numerically more increase in the testicular size & spermetogenesis as comprared
to GT arm but this difference is not statistically significant .We found no adeverse effect of testosterone therapy on the spermatogenesis.


Keywords


Testosterone , Gonadotropin ,Spermatogenesis , Testicular Volume

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