Huang Bingkun, Mao Jiangfeng, Xu Hongli, Wang Xi, Liu Zhaoxiang, Nie Min, Wu Xueyan
Department of Endocrinology/Key Laboratory of Endocrinology, Ministry of Health, Peking Union Medical College Hospital & Chinese Academy of Medical Sciences, Beijing 100730, China.
Department of Endocrinology/Key Laboratory of Endocrinology, Ministry of Health, Peking Union Medical College Hospital & Chinese Academy of Medical Sciences, Beijing 100730, China; Email:
Zhonghua Yi Xue Za Zhi. 2015 May 26;95(20):1568-71.
To compare the efficacies of pulsatile gonadotropin-releasing hormone (GnRH) versus human chorionic gonadotropin/human menopausal gonadotropin (HCG/HMG) for spermatogenesis in male idiopathic hypogonadotropic hypogonadism (IHH).
For this retrospective study, a total of 92 male IHH outpatients from May 2010 to October 2014 were recruited and categorized into GnRH (n = 40) and HCG/HMG (n = 52) groups. Each subject selected one specific therapy voluntarily. The gonadotropin levels were measured in the first week and monthly post-treatment in GnRH group. And serum total testosterone (TT), testicular volume (TV) and rate of spermatogenesis were observed monthly post-treatment in two groups. Spermatogenesis, TT and TV were compared between two groups.
All IHH patients were treated for over 3 months. The median follow-up periods in GnRH and HCG/HMG groups was 8.2 (3.0-18.4) and 9.2 (3.0-18.6) months respectively (P = 0.413). In GnRH group, LH ((0.5 ± 0.6) vs (3.4 ± 2.4) U/L, P < 0.01) and FSH ((1.3 ± 1.1) vs (5.8 ± 3.8) U/L, P < 0.01) increased after 1-week treatment. In GnRH group, at the end of follow-up, TT ((1.0 ± 1.0) vs (7.4 ± 5.2) nmol/L, P < 0.01) and TV ((2.3 ± 1.5) vs (8.1 ± 4.0) ml, P < 0.01) significantly increased compared to baseline. In HCG/HMG group, TT ((0.8 ± 0.6) vs (14.4 ± 8.0) nmol/L, P < 0.01) and TV ((2.3 ± 2.1) vs (7.6 ± 4.2) ml, P < 0.01) significantly increased after therapy. The success rate of spermatogenesis was 50.0% (20/40) in GnRH group versus 28.8% (15/52) in HCG/HMG group (P = 0.038). GnRH group required a shorter treatment time for initial sperm appearance than HCG/HMG group ((6.5 ± 3.1) vs (10.8 ± 3.7) months, P = 0.001).
Pulsatile GnRH requires a shorter time for initiation of spermatogenesis than gonadotropin therapy in IHH male patients.
比较脉冲式促性腺激素释放激素（GnRH）与人绒毛膜促性腺激素/人绝经期促性腺激素（HCG/HMG）对男性特发性低促性腺激素性性腺功能减退症（IHH）患者精子发生的疗效。
本回顾性研究纳入了2010年5月至2014年10月期间共92例男性IHH门诊患者，并将其分为GnRH组（n = 40）和HCG/HMG组（n = 52）。每位受试者自愿选择一种特定治疗方法。GnRH组在治疗第1周及之后每月测量促性腺激素水平。两组在治疗后每月观察血清总睾酮（TT）、睾丸体积（TV）和精子发生率。比较两组之间的精子发生情况、TT和TV。
所有IHH患者均接受了超过3个月的治疗。GnRH组和HCG/HMG组的中位随访期分别为8.2（3.0 - 18.4）个月和9.2（3.0 - 18.6）个月（P = 0.413）。在GnRH组，治疗1周后促黄体生成素（LH）（（0.5 ± 0.6） vs （3.4 ± 2.4）U/L，P < 0.01）和促卵泡生成素（FSH）（（1.3 ± 1.1） vs （5.8 ± 3.8）U/L，P < 0.01）升高。在GnRH组，随访结束时，与基线相比，TT（（1.0 ± 1.0） vs （7.4 ± 5.2）nmol/L，P < 0.01）和TV（（2.3 ± 1.5） vs （8.1 ± 4.0）ml，P < 0.01）显著增加。在HCG/HMG组，治疗后TT（（0.8 ± 0.6） vs （14.4 ± 8.0）nmol/L，P < 0.01）和TV（（2.3 ± 2.1） vs （7.6 ± 4.2）ml，P < 0.01）显著增加。GnRH组精子发生成功率为50.0%（20/40），而HCG/HMG组为28.8%（15/52）（P = 0.038）。GnRH组初始出现精子所需的治疗时间比HCG/HMG组短（（6.5 ± 3.1） vs （10.8 ± 3.7）个月，P = 0.001）。
在IHH男性患者中，脉冲式GnRH启动精子发生所需时间比促性腺激素治疗短。
