A prospective pilot study of co-treatment with growth hormone and gonadotropins for improving spermatogenesis in normogonadotropic patients with severe oligoteratoasthenospermia.

The objective of this study was to induce spermatogenesis by co-treatment with growth hormone and gonadotropins in normogonadotropic patients with severe oligoteratoasthenospermia (OTA) who had failed to respond adequately to conventional therapy. A prospective study in which co-treatment with growth hormone (4 IU) and human menopausal gonadotropin (hMG; 150 IU of follicle-stimulating hormone (FSH) and 150 IU of luteinizing hormone (LH)), three times a week, and human chorionic gonadotropin (hCG; 2500 IU), two times a week for 24 weeks, were administered after unsuccessful treatment for at least 12 weeks with gonadotropins. Four patients who had failed to respond to conventional treatment with gonadotropins participated in the study. Semen volume, sperm production, serum testosterone, LH, FSH, insulin-like growth factor-I (IGF-I) and growth hormone-binding protein concentrations were used to measure outcome. In all four patients, there was no improvement in sperm quality as compared to baseline measurements. Serum testosterone concentrations remained within normal limits. A significant increase in both serum IGF-I and growth hormone-binding protein was found following treatment with growth hormone. Our results do not encourage the use of co-treatment of gonadotropins with growth hormone in cases of normogonadotropic OTA syndrome patients who fail to respond adequately to the conventional therapy with gonadotropins.