Efficacy of Gonadotropin Therapy to Induce Spermatogenesis and Fertility in Men with Pathologic Gonadotropin Deficiency
Authors' conclusion
Most men with pathologic gonadotropin deficiency treated with hCG/FSH achieve sperm output and fertility within a year, with the greatest impact on fertility outcomes being detrimental female fertility factors.
Study context
- Population
- Infertile men with congenital or acquired pathologic gonadotropin deficiency treated with urinary or recombinant hCG and FSH, 1983–2024; men aged 35 ± 1 years, female partners 30 ± 1 years160 treatment cycles
- Participants
- 99 men
- Outcome
- Time to prespecified sperm density thresholds and pregnancy
Methodological detailsconsecutive patients, standardized protocol, Kaplan-Meier and multivariate Cox regression
- Consecutive patients
- Standardized protocol
- Kaplan-Meier and multivariate Cox regression
Main finding
As reported in the abstract
Proportion (median time) achieving sperm thresholds
- >0 M sperm/mL
- 78% (5 months)
- >2 M sperm/mL
- 56% (12 months)
- >5 M sperm/mL
- 49% (14 months)
- >10 M sperm/mL
- 37% (21 months)
- >20 M sperm/mL
- 24% (not determined)
- Adverse female fertility factors and successful pregnancy, HR
- 0.20 (95% CI 0.10-0.40; P < .001)
- Time to pregnancy increased by adverse female factors (P < .0001)
- 15 vs 43 months
Observational data: associations, not effects.
Further findings
Median sperm concentration associated with partner pregnancy
M/mL
- Without adverse female factors
- 2.8 (0.2, 52.6)
- With adverse female factors
- 35.4 (15.1, 52.6)
Original publication
Efficacy of Gonadotropin Therapy to Induce Spermatogenesis and Fertility in Men with Pathologic Gonadotropin Deficiency. J Clin Endocrinol Metab. Published 30 October 2025. doi:10.
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