Hypogonadotropic Hypogonadism in Hemochromatosis: Recovery of Reproductive Function After Iron Depletion

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Abstract
We studied the effect of iron depletion on reproductive function in a 37-year-old man with hypogonadotropic hypogonadism due to idiopathic hemochromatosis. Before therapy, he was important and had no libido, and seminal fluid analysis revealed no spermatozoa. Testicular biospy showed marked impairment of spermatogenesis, but no iron load deposits. Sixteen months after insititution of aggressive phlebotomy therapy, serum LH, FSH, and testosterone were normal, and potency and libido had returned. Twenty months after diagnosis the patient fathered another child. Seminal fluid analysis at that time revealed an average of 65 million spermatozoa/mL. Thus, recovery of reproductive function, documented by hormone measurements, testicular biopsy, and semen analysis, was complete. We conclude that phlebotomy alone may be adequate treatment for hypogonadotropic hypogonadism in men with hemochromatosis.

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