Maintenance of spermatogenesis by intranasal administration of gonadotropin-releasing hormone in patients with hypothalamic hypogonadism.

Pulsatile administration of GnRH is a new, effective therapy for idiopathic hypothalamic hypogonadism. This therapy requires a computerized pump to deliver GnRH intermittently or repetitive single injections each day. In order to simplify this mode of therapy, we first administered hCG to two of three patients to stimulate Leydig cells, and followed this by pulsatile sc administration of GnRH in all three patients. After induction of spermatogenesis, GnRH was administered intranasally, 200 micrograms every 2 h for 8 doses daily. In all patients treated, normal spermatogenesis was maintained by nasal administration of GnRH over a period of 90, 100, and 181 days, respectively. After this period the treatment was arbitrarily discontinued.