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Abstract

Volume 27, Issue 3 (May 2025) 27, 322–329; 10.4103/aja202483

Hypogonadotropic hypogonadism as a cause of NOA and its treatment

Salvio, Gianmaria1; Balercia, Giancarlo1; Kadioglu, Ates2

1Endocrinology Clinic, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, Ancona 60126, Italy
    
    2Section of Andrology, Department of Urology, Istanbul School of Medicine, Istanbul 34093, Türkiye

Correspondence: Dr. G Salvio (g.salvio@staff.univpm.it)

Originally published: October 22, 2024 Received: January 31, 2024 Accepted: August 19, 2024

Abstract

Hypogonadotropic hypogonadism (HH) represents a relatively rare cause of nonobstructive azoospermia (NOA), but its knowledge is crucial for the clinical andrologists, as it represents a condition that can be corrected with medical therapy in 3 quarters of cases. There are forms of congenital HH, whether or not associated with an absent sense of smell (anosmic HH or Kallmann syndrome, and normosmic HH, respectively), and forms of acquired HH. In congenital HH, complete absence of pubertal development is characteristic. On the other hand, if the deficit occurs after the time of pubertal development, as in acquired HH patients, infertility and typical symptoms of late-onset hypogonadism are the main reasons for seeking medical assistance. Gonadotropin-releasing hormone (GnRH) or gonadotropin replacement therapy is the mainstay of drug therapy and offers excellent results, although a small but significant proportion of patients do not achieve sufficient responses.
    
    Keywords: gonadotropins; hypogonadotropic hypogonadism; idiopathic hypogonadism; Kallmann syndrome

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Asian Journal of Andrology CN 31-1795/R ISSN 1008-682X  Copyright © 2023  Shanghai Materia Medica, Chinese Academy of Sciences.  All rights reserved.