Whitten Scott J, Nangia Ajay K, Kolettis Peter N
Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Alabama, Birmingham, Alabama 35249-7333, USA.
Fertil Steril. 2006 Dec;86(6):1664-8. doi: 10.1016/j.fertnstert.2006.05.042. Epub 2006 Sep 27.
To review the management of male hypogonadotropic hypogonadism (HH) and evaluate the efficacy of clomiphene citrate (CC).
Retrospective review.
Two university-based urology clinics.
PATIENT(S): Ten patients referred for male infertility evaluation.
INTERVENTION(S): Patients were treated with either clomiphene citrate or injectable gonadotropins.
MAIN OUTCOME MEASURE(S): Changes in seminal parameters, gonadotropin levels, serum testosterone, and pregnancy.
RESULT(S): Ten men who were evaluated for infertility were diagnosed with HH. Four had Kallmann's syndrome, four idiopathic HH, and two panhypopituitarism. Eight patients were azoospermic, and two were oligospermic on presentation. Three of the four men with adult-onset idiopathic HH responded to CC alone with increases in testosterone, FSH, and LH. Semen parameters in this group also improved, and two of the three men achieved pregnancies with CC alone. Out of the ten men actively attempting conception, four pregnancies were achieved. Three pregnancies (two with CC and one with gonadotropins) were in men diagnosed with adult-onset idiopathic forms of HH.
CONCLUSION(S): Select patients with adult-onset idiopathic forms of HH may benefit from a trial of clomiphene citrate.
回顾男性低促性腺激素性性腺功能减退（HH）的治疗情况，并评估枸橼酸氯米芬（CC）的疗效。
回顾性研究。
两家大学附属医院的泌尿外科门诊。
10名因男性不育前来评估的患者。
患者接受枸橼酸氯米芬或注射用促性腺激素治疗。
精液参数、促性腺激素水平、血清睾酮水平的变化以及妊娠情况。
10名接受不育评估的男性被诊断为HH。其中4例患有卡尔曼综合征，4例为特发性HH，2例为全垂体功能减退。初诊时，8例患者无精子症，2例少精子症。4例成年起病的特发性HH患者中，有3例单独使用CC后睾酮、促卵泡生成素（FSH）和促黄体生成素（LH）水平升高。该组患者的精液参数也有所改善，3例中的2例单独使用CC后成功受孕。在10名积极尝试受孕的男性中，有4例成功妊娠。3例妊娠（2例使用CC，1例使用促性腺激素）发生在被诊断为成年起病的特发性HH的男性中。
部分成年起病的特发性HH患者可能从枸橼酸氯米芬试验中获益。
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