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Abstract

Volume 17, Issue 3 (May 2015) 17, 497–502; doi: 10.4103/1008-682X.145072

Reversal of idiopathic hypogonadotropic hypogonadism: a cohort study in Chinese patients

Jiang-Feng Mao1,*, Hong-Li Xu1,*, Jin Duan2,3, Rong-Rong Chen2,3, Li Li2, Bin Li2,3, Min Nie1, Le Min4, Hong-Bing Zhang2, Xue-Yan Wu1

1Department of Endocrinology, Peking Union Medical College Hospital, Key Laboratory of Endocrinology, Ministry of Health, Beijing 100730, China,
2State Key Laboratory of Medical Molecular Biology, Department of Physiology, Institute of Basic Medical Sciences and School of Basic Medicine, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100005, China
3Beijing Genomics Institute at Shenzhen, Shenzhen 518083, China
4Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA

Correspondence: Dr. XY Wu (wsheyan@vip.sina.com)

2014-12-23

Abstract

Although idiopathic hypogonadotropic hypogonadism (IHH) has traditionally been viewed as a life‑long disease caused by a deficiency of gonadotropin‑releasing hormone neurons, a portion of patients may gradually regain normal reproductive axis function during hormonal replacement therapy. The predictive factors for potential IHH reversal are largely unknown. The aim of our study was to investigate the incidence and clinical features of IHH male patients who had reversed reproductive axis function. In this retrospective cohort study, male IHH patients were classified into a reversal group (n = 18) and a nonreversal group ( 336). Concentration of gonadotropins and testosterone, as well as testicle sizes and sperm counts, were determined. Of 354 IHH patients, 18 (5.1%) acquired normal reproductive function during treatment. The median age for reversal was 24 years old (range 21–34 years). Compared with the nonreversal group, the reversible group had higher basal luteinizing hormone (LH) (1.0 ± 0.7 IU l-1 vs 0.4 ± 0.4 IU l−1, P < 0.05) and stimulated LH (28.3 ± 22.6 IU l−1 vs 1.9 ± 1.1 IU l−1,  0.01) levels, as well as larger testicle size (5.1 ± 2.6 ml vs 1.5 ± 0.3 ml,  0.01), at the initial visit. In summary, larger testicle size and higher stimulated LH concentrations are favorite parameters for reversal. Our finding suggests that reversible patients may retain partially active reproductive axis function at initial diagnosis.

Keywords: hypothalamic‑pituitary‑gonadal axis; idiopathic hypogonadotropic hypogonadism; reversal

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