الفهرس | Only 14 pages are availabe for public view |
Abstract Hypogonadotropic hypogonadism (HH) is a disorder characterized by delayed puberty due to defective production of follicle stimulating hormone (FSH) and lutenizing hormone (LH) from the pituitary. HH can be due to congenital, idiopathic or acquired causes. FSH is the major endocrine regulator of sertoli cell function and spermatogenesis. The sertoli cell is the only cell type in the testis that expresses receptors for FSH which is necessary for adequate sertoli cell proliferation and conditioning of spermatogonia. Sertoli cells produce and secrete inhibin B into the circulation as a response to FSH stimulation and inhibin B negatively regulates FSH. Recombinant human FSH increases plasma concentrations of inhibin B. while human chorionic gonadotropin (hCG) stimulates testosterone production from leydig cells. Various studies on HH were performed using different treatment protocols with either FSH priming, or hCG monotherapy followed by combined therapy with both FSH and hCG using variable doses and durations. In our study 20 male patients diagnosed with HH were recruited from pediatric endocrinology clinic, patients were divided into two groups; group 1: received combined treatment with both FSH and hCG for 12 months, group 2: received FSH priming for 3 months followed by combined FSH and hCG for another 9 months. Baseline clinical and laboratory data were obtained at the beginning of the study, regular follow up was done, clinical and laboratory evaluation was repeated at the end of our study. Our study demonstrated that both treatment protocols used were equally effective as regards increase in testicular volumes, or spermatogenesis after 12 months of therapy. |