Restoration and Maintenance of Spermatogenesis by HCG Therapy in Patients with Hypothalamo-Hypophyseal Damage

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Abstract
Both gonadotropins are necessary to induce spermatogenesis in man and to recover hypophysectomized males. The patients who suffer from tumoral or traumatic hypothalamo-hypophyseal lesion may have low endogenous gonadotropins (opposite to hypophysectomized patients), which can produce a minor involution of spermatogenesis. Three patients with postpuberal hypogonadotropic hypogonadism and oligozoospermia were studied. Two of them were operated on for chromophobous adenoma of pituitary, and the other patient had a traumatic hypothalamo-hypophyseal lesion. The 3 patients were treated with 5000 IU HCG [human chorionic gonadotropin]/wk, associated with testosterone enanthate, in 2 cases and with bromocriptine in the remaining one. All the patients had normalized spermiogram, but when HCG was interrupted, the sperm count regressed to pretreatment levels in spite of the maintenance of treatment with testosterone or bromocriptine. Minimal amounts of FSH, together with the testosterone supplied by Leydig cell under the HCG stimulus, are able to recover and maintain the spermatogenesis in these patients.