Hypergonadotropic Hypogonadism: Management of Infertility.

Hypergonadotropic hypogonadism aromatase inhibitors empirical medical treatment gonadotropins male infertility selective estrogen receptor modulators.

Journal

Current pharmaceutical design
ISSN: 1873-4286
Titre abrégé: Curr Pharm Des
Pays: United Arab Emirates
ID NLM: 9602487

Informations de publication

Date de publication:
Historique:
received: 31 03 2020
accepted: 16 08 2020
pubmed: 4 11 2020
medline: 25 2 2023
entrez: 3 11 2020
Statut: ppublish

Résumé

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. The aim of this review was to evaluate treatment options for infertile men with hypergonadotropic hypogonadism. 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. 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. 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.

Sections du résumé

BACKGROUND 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 OBJECTIVE
The aim of this review was to evaluate treatment options for infertile men with hypergonadotropic hypogonadism.
METHODS 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 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 CONCLUSIONS
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.

Identifiants

pubmed: 33138760
pii: CPD-EPUB-111074
doi: 10.2174/1381612826666201102110456
doi:

Substances chimiques

Aromatase Inhibitors 0
Selective Estrogen Receptor Modulators 0

Types de publication

Journal Article Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

2790-2795

Informations de copyright

Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.

Auteurs

Arif Kalkanli (A)

Department of Urology, Taksim Education and Research Hospital, Istanbul, Turkey.

Hakan Akdere (H)

Department of Urology, Trakya University, Medical Faculty, Edirne, Turkey.

Gökhan Cevik (G)

Department of Urology, Trakya University, Medical Faculty, Edirne, Turkey.

Emre Salabas (E)

Department of Urology, Biruni University Hospital, Istanbul, Turkey.

Nusret Can Cilesiz (NC)

Section of Andrology, Department of Urology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.

Ateş Kadioglu (A)

Section of Andrology, Department of Urology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.

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Classifications MeSH