RECOVERY OF FERTILITY IN A HYPOGONADOTROPIC MAN APPARENTLY RESISTANT TO GONADOTROPHIN TREATMENT

Two subjects affected by panhypopituitarism, 17 and 19 years of age, were evaluated. One of the patients was able to ejaculate sperm (14 ± 106/ml) after 12 months of hMG-hCG therapy (75 IU 2± IRP HMG + 850 IU hCG twice a week). In the other subject sperm production was not achieved until 6 1/2 years of uninterrupted therapy had been completed although the hCG doses were doubled and then quadrupled.In the patient who responded promptly to the therapy, blood levels of both FSH (2.5) and LH (1.7 (mUI/ml 2± IRP hMG-RIA methods) were indeed detectable though very low. In the patient resistant to the therapy, FSH levels were still detectable (2.2 mUI/ml), but LH was undetectable at all. The seminiferous tubules of this patient contained few spermatogonia, and these would be attributed to the action of FSH by itself. However, the importance of endogenous LH in determining the maturation of the testes is stressed by the very long period of hCG therapy required to obtain in this patient ejaculations of sperm.Caref...