Treatment situation of male hypogonadotropic hypogonadism in pediatrics and proposal of testosterone and gonadotropins replacement therapy protocols

• DOI: 10.1297/cpe.24.37
• Publication Date: 2015-05-14T22:01:17Z
• Authors: Naoko Sato; Tomonobu Hasegawa; Yukihiro Hasegawa; Osamu Arisaka; Keiichi Ozono; Shin Amemiya; Toru Kikuchi; Hiroyuki Tanaka; Shohei Harada; Ichiro Miyata; Toshiaki Tanaka
• Keywords: Delayed puberty; Kallmann syndrome; Hypothalamic disease; Gonadotropin

Male hypogonadotropic hypogonadism (MHH), a disorder associated with infertility, is treated testosterone replacement therapy (TRT) and/or gonadotropins (GRT) (TRT and GRT, together HRT hormone therapy). In Japan, guidelines have been set for treatment during adolescence. Due to the risk of rapid maturation bone age, low doses or used. However, optimal timing methods therapeutic intervention not yet established. The objective this study was investigate current situation children MHH in Japan review primary survey involving councilors Japanese Society Pediatric Endocrinology secondary obtained from 26 facilities conducting HRT. subjects were 55 patients who reached their adult height after breakdown as follows: 7 Kallmann syndrome, 6 isolated gonadotropin deficiency, 18 acquired hypopituitarism due intracranial pituitary tumor, 22 classical idiopathic breech delivery, 2 CHARGE syndrome. mean age at start 15.7 yrs 157.2 cm. reaching 19.4 yrs, 171.0 starting later than normal pubertal showed significant negative correlation gain, but it no height. As spermatogenesis, 76% above hCG-rFSH combined positive results, though ranging levels; impaired spermatogenesis observed some congenital MHH, favorable all MHH. From above, we propose establishment protocol low-dose by dividing into two groups determine different protocols, conduct them closer onset puberty, namely, near entrance junior high school. We also new using preemptive FSH prior GRT aimed achieving future fertility