When the testes fail, does treatment with gonadotrophins help?

This paper studies the effect of gonadotrophin treatment on quality of life compared with testosterone treatment in patients with male hypogonadotrophic hypogonadism (failure of the testes).

Male hypogonadotrophic hypogonadism is the failure of the testes that results in a decrease of testosterone and sperm production. It can be treated with gonadotrophins (hormones that control the development and function of the ovaries and testes) that stimulate both sperm and testosterone production. This may improve the health-related quality of life of patients. The authors studied gonadotrophin treatment on patient satisfaction. 

37 patients with male hypogonadotrophic hypogonadism were included in the study. Patients requiring infertility treatment were excluded. 6 patients underwent testosterone treatment. 31 patients received human chorionic gonadotrophin (induces production of testosterone in testes) for 6 months, followed by follicle stimulating hormone (regulates reproduction). Treatment lasted for 2 years, and patients completed a health survey questionnaire before treatment and every 6 months for the 2 years.

After gonadotrophin treatment, the average volume of the testes increased twofold.  Of the patients who underwent semen examinations during treatment period, 88% observed sperm or an increased number of sperm. The average sperm concentration was 12.4 X 10⁶/ml. The average sperm motility (ability of sperm to move) was 57.1%. The average semen volume also significantly increased after gonadotrophin treatment.

The health questionnaire scores for men with hypogonadotrophic hypogonadism were generally much lower than the normal average. Both gonadotrophin and testosterone treatments significantly improved physical function of patients after 12 months. In assessing general health, the influence of emotions on the ability to undertake daily tasks, vitality and mental health, increases in satisfaction were observed in those receiving gonadotrophin but not testosterone.

The authors concluded that gondaotrophin treatment could prevent negative physical and psychological effects in male hypogonadotrophic hypogonadism.