New technologies in the treatment of hypogonadotropic hypogonadism in pediatric practice

• Oleg Yu. Latyshev
• Brzhezinskaya Lyubov’ B.
• Goar F. Okminyan
• Elena V. Kiseleva
• Kristina D. Kokoreva
• Lyubov’ N. Samsonova
• Elvira P. Kasatkina

Abstract

The problem of therapy of hypogonadotropic hypogonadism has been the focus of attention of a pediatric endocrinologist for several years. The advantages and disadvantages of treatment with a combination of recombinant follicle stimulation hormone (rFSH) and human chorionic gonadotropin (hCG) compared to monotherapy with human chorionic gonadotropin or testosterone are still under discussion. The use of testosterone replacement therapy helps to induce the development of secondary sexual characteristics effectively and for a short time. It's also low-cost and associated with a high level of adherence. However this didn't show an effect on testicular volume and fertility. Moreover, the negative effect of testosterone replacement therapy on reproductive function cannot be ruled out. Using hCG can increase testicular volume but also doesn't improve fertility prognosis. Combination therapy of rFSH and hCG can potentially improve fertility but the development of androgen dependent signs of puberty is slower. Meanwhile the number of injections and the cost of this treatment are higher compared with testosterone or hCG monotherapy. Moreover the age of initiation of therapy and successful replacement therapy regimens has not been evaluated.

The clinical case of treatment of hypogonadotropic hypogonadism with a combination of rFSH and hCG is presented. Changes in hormonal levels and testicular volume are also analyzed and presented.

Keywords:hypohonadism, puberty delay, testosterone, chorionic gonadotropin, inhibin B

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