Select patients with hypogonadotropic hypogonadism may respond to treatment with clomiphene citrate
Select patients with hypogonadotropic hypogonadism may respond to treatment with clomiphene citrate
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DOI：
10.1016/j.fertnstert.2006.05.042
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发表时间：
2006-12-01
影响因子：
6.7
通讯作者：
Kolettis, Peter N.
中科院分区：
文献类型：
--
作者：
Whitten, Scott J.;Nangia, Ajay K.;Kolettis, Peter N.
目的：回顾性分析男性低促性腺激素性性腺功能减退症（HH）的治疗并评价克罗米芬（CC）的疗效。设计：回顾性分析。设置：两所大学的泌尿科诊所。患者：10名男性不育症患者。干预：患者接受克罗米芬或注射促性腺激素治疗。主要结果测量：精液参数、促性腺激素水平、血清睾酮和妊娠的变化。结果：10名男性被诊断为HH。4例有卡尔曼综合征，4例特发性HH，2例全垂体功能减退症。8例患者无精子症，2例表现为少精子症。4例成人型特发性HH患者中有3例对CC单独治疗有反应，睾酮、FSH和LH升高。该组的精液参数也有所改善，三名男性中有两名单独使用CC怀孕。在积极尝试受孕的10名男子中，有4人怀孕。三个怀孕（两个CC和促性腺激素）被诊断为成人发病的特发性形式的HH的男性。结论（S）：选择患者与成人发病的特发性形式的HH可能会受益于克罗米芬柠檬酸盐的试验。
Objective: To review the management of male hypogonadotropic hypogonadism (HH) and evaluate the efficacy of clomiphene citrate (CC).Design: Retrospective review.Setting: Two university-based urology clinics.Patient(s): Ten patients referred for male infertility evaluation.Intervention(s): Patients were treated with either clomiphene citrate or injectable gonadotropins.Main Outcome Measure(s): Changes in seminal parameters, gonadotropin levels, serum testosterone, and pregnancy.Result(s): Ten men who were evaluated for infertility were diagnosed with HH. Four had Kallmann's syndrome, four idiopathic HH, and two panhypopituitarism. Eight patients were azoospermic, and two were oligospermic on presentation. Three of the four men with adult-onset idiopathic HH responded to CC alone with increases in testosterone, FSH, and LH. Semen parameters in this group also improved, and two of the three men achieved pregnancies with CC alone. Out of the ten men actively attempting conception, four pregnancies were achieved. Three pregnancies (two with CC and one with gonadotropins) were in men diagnosed with adult-onset idiopathic forms of HH.Conclusion(s): Select patients with adult-onset idiopathic forms of HH may benefit from a trial of clomiphene citrate.