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Male infertility and gonadotropin treatment: What can we learn from real-world data?

Abstract
Gonadotropin therapy to treat specific male infertility disorders associated with hypogonadotropic hypogonadism is evidence-based and effective in restoring spermatogenesis and fertility. In contrast, its use to improve fertility in men with idiopathic oligozoospermia or nonobstructive azoospermia remains controversial, despite being widely practiced. The existence of two major inter-related pathways for spermatogenesis, including FSH and intratesticular testosterone, provides a rationale for empiric hormone stimulation therapy in both eugonadal and hypogonadal males with idiopathic oligozoospermia or nonobstructive azoospermia. Real-world data (RWD) on gonadotropin stimulating for these patient subsets, mainly using human chorionic gonadotropin and follicle-stimulating hormone, accumulated gradually, showing a positive therapeutic effect in some patients, translated by increased sperm production, sperm quality, and sperm retrieval rates. Although more evidence is needed, current insights from RWD research indicate that selected male infertility patients might be managed more effectively using gonadotropin therapy, with potential gains for all parties involved.
AuthorsSandro C Esteves, Arnold P P Achermann, Manuela Simoni, Daniele Santi, Livio Casarini
JournalBest practice & research. Clinical obstetrics & gynaecology (Best Pract Res Clin Obstet Gynaecol) Vol. 86 Pg. 102310 (Feb 2023) ISSN: 1532-1932 [Electronic] Netherlands
PMID36682942 (Publication Type: Journal Article, Review)
CopyrightCopyright © 2023 Elsevier Ltd. All rights reserved.
Chemical References
  • Luteinizing Hormone
  • Follicle Stimulating Hormone
  • Chorionic Gonadotropin
  • Testosterone
Topics
  • Male
  • Humans
  • Azoospermia (drug therapy)
  • Oligospermia (drug therapy)
  • Luteinizing Hormone (therapeutic use)
  • Semen
  • Follicle Stimulating Hormone (therapeutic use)
  • Chorionic Gonadotropin (therapeutic use)
  • Infertility, Male (drug therapy)
  • Hypogonadism (complications, drug therapy)
  • Testosterone (therapeutic use)

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