The effectiveness of zinc supplementation in men with isolated hypogonadotropic hypogonadism

• DOI: 10.4103/1008-682x.189621
• Publication Date: 2017-05-05T05:10:35Z
• Authors: Da-Long Zhu; Xiao-Ying Li; Yan-Ling Liu; Man-Na Zhang; Guo-Yu Tong; Shou-Yue Sun; Yan-Hua Zhu; Ying Cao; Jie Zhang; Hong Huang; Ben Niu; Hong Li; Qing-Hua Guo; Yan Gao
• Keywords: Adult; Male; Adolescent; Chorionic Gonadotropin; gonadotropin; isolated hypogonadotropic hypogonadism; masculinization; spermatogenesis; zinc supplementation; Young Adult; 03 medical and health sciences; 0302 clinical medicine; Testis; Humans; Testosterone; Spermatogenesis; Sperm Count; Hypogonadism; Luteinizing Hormone; Middle Aged; Diseases of the genitourinary system. Urology; Trace Elements; 3. Good health; Treatment Outcome; Dietary Supplements; Sperm Motility; Original Article; RC870-923; Follicle Stimulating Hormone; Gonadotropins; Penis

A multicenter, open-label, randomized, controlled superiority trial with 18 months of follow-up was conducted to investigate whether oral zinc supplementation could further promote spermatogenesis in males with isolated hypogonadotropic hypogonadism (IHH) receiving sequential purified urinary follicular-stimulating hormone/human chorionic gonadotropin (uFSH/hCG) replacement. Sixty-seven Chinese male IHH patients were recruited from the Departments of Endocrinology in eight tertiary hospitals and randomly allocated into the sequential uFSH/hCG group (Group A, n = 34) or the sequential uFSH plus zinc supplementation group (Group B, n = 33). In Group A, patients received sequential uFSH (75 U, three times a week every other 3 months) and hCG (2000 U, twice a week) treatments. In Group B, patients received oral zinc supplementation (40 mg day-1 ) in addition to the sequential uFSH/hCG treatment given to patients in Group A. The primary outcome was the proportion of patients with a sperm concentration ≥1.0 × 106 ml-1 during the 18 months. The comparison of efficacy between Groups A and B was analyzed. Nineteen of 34 (55.9%) patients receiving sequential uFSH/hCG and 20 of 33 (60.6%) patients receiving sequential uFSH/hCG plus zinc supplementation achieved sperm concentrations ≥1.0 × 106 ml-1 by intention to treat analyses. No differences between Group A and Group B were observed as far as the efficacy of inducing spermatogenesis (P = 0.69). We concluded that the sequential uFSH/hCG plus zinc supplementation regimen had a similar efficacy to the sequential uFSH/hCG treatment alone. The additional improvement of 40 mg day-1 oral zinc supplementation on spermatogenesis and masculinization in male IHH patients is very subtle.