Efficacy of Gonadotropin Treatment for Induction of Spermatogenesis in Men With Pathologic Gonadotropin Deficiency: A Meta‐Analysis
Authors' conclusion
Gonadotropin treatment successfully induced spermatogenesis in most men with pathological gonadotropin deficiency. Sperm outputs more consistent with those typically needed to induce a natural pregnancy were less commonly achieved. Despite similar effects on serum testosterone and TV, combined hCG/FSH appeared more efficacious than hCG alone at inducing spermatogenesis.
Study context
- Population
- Men with pathologic gonadotropin deficiency (hypogonadotropic hypogonadism (HH)) and nonobstructive azoospermic infertility; mean age 25 (± 5) years
- Participants
- 1,673 men41 studies
- Comparison
- Gonadotropin treatment
- Outcome
- Sperm concentration after gonadotropin treatment
- Follow-up
- Median of 18 months
Pooled result
As reported in the abstract
- Average sperm concentration achieved
- 11.6 M/mL of ejaculate (95% CI 8.4-14.9)
- Sperm concentration > 0 M/mL
- 78%
- Sperm concentration > 1 M/mL
- 55%
- Sperm concentration > 5 M/mL
- 36%
- Sperm concentration > 10 M/mL
- 24%
- Sperm concentration > 20 M/mL
- 15%
Further pooled results
Sperm output and sperm thresholds by treatment
- Mean sperm output and proportion achieving all sperm thresholds significantly greater with combined hCG/FSH vs hCG monotherapy
Sperm output by diagnosis
- Congenital HH (CHH) had significantly lower mean sperm output vs hypopituitarism or mixed cohorts
Testosterone and testicular volume (TV)
- Treatment-related increases in testosterone and TV not different between hCG and combined hCG/FSH
- Increases in TV lower in CHH vs hypopituitarism
Original publication
Efficacy of Gonadotropin Treatment for Induction of Spermatogenesis in Men With Pathologic Gonadotropin Deficiency: A Meta‐Analysis. Clin Endocrinol (Oxf). Published 24 October 2024. doi:10.
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