Research and Reports in Urology (Jun 2021)
Evaluating the Combination of Human Chorionic Gonadotropin and Clomiphene Citrate in Treatment of Male Hypogonadotropic Hypogonadism: A Prospective Study
Abstract
The Son Trinh,1 Nguyen Ba Hung,2,3 Le Thi Thu Hien,2 Ngo Anh Tuan,4 Dinh Cong Pho,5 Quan Anh Dung,6 Duc Anh Do,7 Ha Duc Quang,2 Hoang Van Ai,1 Pham Ngoc Hung8,9 1Military Institute of Clinical Embryology and Histology, Vietnam Military Medical University, Hanoi, Vietnam; 2Andrology and Fertility Hospital of Hanoi - AF Hanoi, Hanoi, Vietnam; 3Vinmec Times City International Hospital, Hanoi, Vietnam; 4Department of Health Economics, Vietnam Military Medical University, Hanoi, Vietnam; 5Department of Infection Control, Military Hospital 103, Vietnam Military Medical University, Hanoi, Vietnam; 6Faculty of Medicine, Vietnam Military Medical University, Hanoi, Vietnam; 7Faculty of Medicine, University of Medical Sciences of Revolutionary Armed Force (UCIMED de Las FAR), Marianao, Havana, Cuba; 8Department of Epidemiology, Vietnam Military Medical University, Hanoi, Vietnam; 9Department of Training, Vietnam Military Medical University, Hanoi, VietnamCorrespondence: Pham Ngoc HungVietnam Military Medical University, Ha Dong District, Hanoi, 100000, VietnamTel +84939613388Email [email protected]: In this study, we evaluated MHH patients who wished to preserve fertility, assessing the efficacy of a short course (12 months) of a combined hCG +clomiphene citrate.Materials and Methods: The cross-sectional study included 19 patients with hypogonadotropic hypogonadism who were admitted to the Andrology and Fertility Hospital of Hanoi between March 2016 and March 2018. Using hCG every three days in combination with clomiphene citrate 25mg per day until normal testosterone levels are reached, maintain the dose until spermatozoa are present.Results: The mean age was 30.2 ± 5.6. Differences in penis length between the time before and after treatment were significant (p=0.005). The average dose of hCG using in our study was 5579 ± 1773.7 IU. After treatment 6 months and 12 months, the changes in clinical features in all patients and the total hypogonadotropic hypogonadism group were statistically significant (p< 0.001). In particular, the differences in testosterone hormone levels in the partial hypogonadotropic hypogonadism group were also statistically significant (p=0.03). No adverse event was observed in our study. The number of patients appearing sperm in the semen is 9 patients (47.4%) after 12 months, but most of the sperm were completely deformed (< 1%), and the average motility in the progressive motility group was below 8%.Conclusion: In conclusion, a combination of hCG and clomiphene citrate may be an option for MHH patients who desired fertility. After 12 months, 47.4% of patients have sperm in semen but almost all of them were deformity. Hormone profile and secondary sexual characteristics improved significantly. There was no adverse event in our study that considered it as safe therapy.Keywords: male hypogonadotropic hypogonadism, MHH, total HH, total hypogonadotropic hypogonadism, partital HH, partial hypogonadotropic hypogonadism, clomiphene citrate, CC, human chorionic gonadotropin, hCG, treatment
