Spermatogenesis of combined HCG and HMG in patients with idiopathic hypogonadotropic hypogonadism and congenital combined pituitary hormone deficiency
10.3760/cma.j.cn311282-20211021-00673
- VernacularTitle:HCG/HMG联合治疗IHH与CCPHD患者的生精相关因素分析
- Author:
Weijie WANG
1
;
Mingwei SHAO
;
Yuansi CHEN
;
Yaya FAN
;
Mengqing LIAN
;
Shanshan WANG
;
Xiaotong WANG
;
Guijun QIN
Author Information
1. 郑州大学第一附属医院内分泌科 450052
- Keywords:
Hypogonadotropic hypogonadism;
Spermatogenesis;
Human chorionic gonadotropin;
Human menopausal gonadotropin
- From:
Chinese Journal of Endocrinology and Metabolism
2022;38(7):601-607
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the spermatogenes response of human chorionic gonadotropin(HCG)combined with human menopausal gonadotropin(HMG)in patients with idiopathic hypogonadotropic hypogonadism(IHH)and congenital combined pituitary hormone deficiency(CCPHD), and to explore related factors.Methods:Clinical data of 90 IHH patients and 61 CCPHD patients from January, 2014 to November, 2018 were retrospectively analyzed. Spermatogenesis was compared between the two groups receiving combined gonadotropin therapy. The patients were then divided into two subgroups: spermatogenesis subgroup and nonspermatogenesis subgroup. Related factors of spermatogenesis after the combined gonadotropin therapy were investigated.Results:After the combined treatment of HCG/HMG for 3, 6, and 9 months, the patients with CCPHD revealed lower testicular sizes than those with IHH( P=0.004, 0.021 and 0.032, respectively). Compared with IHH patients, CCPHD patients had larger testicular volume increments( P<0.001), higher spermatogenesis rates( P=0.048), and shorter initial time for sperm appearance( P<0.001)after 24-month treatment. Multivariate logistic regression analysis showed that lower total cholesterol(TC)(IHH group: OR=5.508, 95% CI 1.110-27.326, P=0.037; CCPHD group: OR=4.068, 95% CI 1.077-15.371, P=0.039)was an independent risk factor of poorer spermatogenesis in patients with IHH and CCPHD. Conclusions:The patients with CCPHD demonstrate a better response to combined gonadotropin treatment than those with IHH. Lower TC is an independent risk factor for poor spermatogenesis of combined HCG/HMG therapy in patients with IHH or CCPHD.
