Paternity in idiopathic hypothalamic hypogonadism during testosterone therapy in two unrelated patients.

When fertility is desired, idiopathic hypothalamic hypogonadism is amenable to treatment with pulsatile low dosage GnRH administration or injections of gonadotrophins. Patients with this disorder are hypogonadal and require therapy with androgens or oestrogens/progestagens. This would presumably lower pituitary gonadotrophin production even further. However, fertility occurring spontaneously during testosterone substitution, as proven by paternity testing, has been described twice. The present report adds two more cases. It is unwise to make a definite statement about infertility in male patients with this condition.