Gonadotropin Releasing Hormone Pump in the Treatment of Hypogonadotropic Hypogonadism: A Report of One Case and the Literature Review_West China Medical Journal

Authors：

 MiaoHongyun ¹ ,  RenWei ² , DengHuacong ² , WangZhihong ² , LongJian ² , LiBin ¹

1. Department of Nephrology and Endocrinology, Jiangjin District Central Hospital of Chongqing City, Chongqing 402260, P. R. China;
2. Department of Endocrinology, the First Hospital Affiliated to Chongqing Medical University, Chongqing 400016, P. R. China;

Corresponding author：

RenWei, Email: weiren67@aliyun.com

Keywords：

Hypogonadotropic hypogonadism; Gonadotropin releasing hormone pump; Therapy

DOI：

10.7507/1002-0179.20160006

Video：

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Objective To research on the clinical efficacy of gonadotropin releasing hormone (GnRH) pump in the treatment of hypogonadotropic hypogonadism (HH) by using micropulse pump subcutaneous pump Gonadorelin to treat patients with HH. Methods Through the report of one case of GnRH pump treatment patient and related literature review, we studied the effect of GnRH pump therapy and the traditional treatment on HH patients' sex hormone level, secondary sexual characteristics, spermatogenesis and pregnancy rate. Results Through treatment, GnRH pump effectively improved the patient's sex hormone level, secondary sexual characteristics development and sperm production ability, and eventually the patient attained the goal of fertility. The patient had a change in his voice tone; Beard and armpit hair grew out; The patient had a good mood with sexual drive; luteotropic hormone, follicle-stimulating hormone and testosterone became normal. The patient's sperm density was 20×10⁹/L, and the average sperm motility was higher than 30%. Conclusion Pulse pump GnRH conforms to the physiological rhythm of GnRH secretion with a good clinical efficacy and tolerance. So we recommend GnRH pump as the preferential choice for treatment of hypogonadotropic hypogonadism.

Citation： MiaoHongyun, RenWei, DengHuacong, WangZhihong, LongJian, LiBin. Gonadotropin Releasing Hormone Pump in the Treatment of Hypogonadotropic Hypogonadism: A Report of One Case and the Literature Review. West China Medical Journal, 2016, 31(1): 21-24. doi: 10.7507/1002-0179.20160006 Copy

1.	伍学焱, 史轶蘩, 邓洁英, 等. 大庆市健康男性青少年正常青春发育时间调查[J]. 中华医学杂志, 2007, 87(16):1117-1119.
2.	Brioude F, Bouligand J, Trabado S, et al. Non-syndromic congenital hypogonadotropic hypogonadism:clinical presentation and genotype-phenotype relationships[J]. Eur J Endocrinol, 2010, 162(5):835-851.
3.	Salenave S, Trabado S, Maione L, et al. Male acquired hypogonadotropic hypogonadism:diagnosis and treatment[J]. Ann Endocrinol (Paris), 2012, 73(2):141-146.
4.	Raivio T, Falardeau J, Dwyer A, et al. Reversal of idiopathic hypogonadotropic hypogonadism[J]. N Engl J Med, 2007, 357(9):863-873.
5.	刘彦玲, 张曼娜, 郭清华, 等. hCG和u-FSH序贯治疗低促性腺激素性腺功能减退症疗效和安全性评估[C]//中华医学会第十一次全国内分泌学学术会议论文汇编. 北京:中华医学会, 2012:155.
6.	Topaloglu AK, Kotan LD. Molecular causes of hypogonadotropichypogonadism[J]. Curr Opin Obstet Gynecol, 2010, 22(4):264-270.
7.	郑郁. 促性腺激素释放激素兴奋试验对性发育疾病的诊断价值[D]. 天津:南开大学, 2012.
8.	Yang L, Zhang SX, Dong Q, et al. Application of hormonal treatment in hypogonadotropic hypogonadism:more than ten years experience[J]. Int Urol Nephrol, 2012, 44(2):393-399.
9.	Attia AM, Al-Inany HG, Proctor ML. Gonadotrophins for idiopathic male factor subfertility[J]. Cochrane Database Syst Rev, 2006, 17(1):CD005071.
10.	Ishikawa T, Ooba T, Kondo Y, et al. Assessment of gonadotropin therapy in male hypogonadotropic hypogonadism[J]. Fertil Steril, 2007, 88(6):1697-1699.
11.	母义明, 李江源, 李永峰. 特发性低促性腺激素性性腺功能减退症患者黄体生成素脉冲分泌分析[J]. 中华内科杂志, 1995, 34(9):587-590.
12.	孙启虹, 窦京涛. 男性低促性腺激素性性腺功能减退的临床诊断及药物治疗[J]. 药品评价, 2013, 10(7):21-28.
13.	Liu L, Banks SM, Barnes KM, et al. Two-year comparison of testicular responses to pulsatile gonadotropin-releasing hormone and exogenous gonadotropins from the inception of therapy in men with isolated hypogonadotropic hypogonadism[J]. J Clin Endocrinol Metab, 1988, 67(6):1140-1145.
14.	Schopohl J, Mehltretter G, Von Zumbusch R, et al. Comparison of gonadotropin-releasing hormone and gonadotropin therapy in male patients with idiopathic hypothalamic hypogonadism[J]. Fertil Steril, 1991, 56(6):1143-1150.
15.	Delemarre-Van de Waal HA. Induction of testicular growth and spermatogenesis by pulsatile, intravenous administration of gonadotrophin-releasing hormone in patients with hypogonadotrophic hypogonadism[J]. Clin Endocrinol (Oxf), 1993, 38(5):473-480.
16.	Pitteloud N, Hayes FJ, Dwyer A, et al. Predictors of outcome of long-term GnRH therapy in men with idiopathic hypogonadotropic hypogonadism[J]. J Clin Endocrinol Metab, 2002, 87(9):4128-4136.
17.	孙首悦, 王卫庆, 王毅峰, 等. GnRH脉冲输注治疗低促性腺激素性发育不全症症[C]//中华医学会第二届糖尿病及性腺疾病学术会议论文集. 北京:中华医学会, 2012:20.
18.	金楠, 母义明. GnRH泵治疗低促性腺激素性性腺功能减退[J]. 药品评价, 2013, 10(7):10-13.
19.	Christin-Maitre S, De Crécy M, Groupe Français des pompes à GnRH. Pregnancy outcomes following pulsatile GnRH treatment:results of a large multicenter retrospective study[J]. J Gynecol Obstet Biol Reprod (Paris), 2007, 36(1):8-12.

1. 伍学焱, 史轶蘩, 邓洁英, 等. 大庆市健康男性青少年正常青春发育时间调查[J]. 中华医学杂志, 2007, 87(16):1117-1119.
2. Brioude F, Bouligand J, Trabado S, et al. Non-syndromic congenital hypogonadotropic hypogonadism:clinical presentation and genotype-phenotype relationships[J]. Eur J Endocrinol, 2010, 162(5):835-851.
3. Salenave S, Trabado S, Maione L, et al. Male acquired hypogonadotropic hypogonadism:diagnosis and treatment[J]. Ann Endocrinol (Paris), 2012, 73(2):141-146.
4. Raivio T, Falardeau J, Dwyer A, et al. Reversal of idiopathic hypogonadotropic hypogonadism[J]. N Engl J Med, 2007, 357(9):863-873.
5. 刘彦玲, 张曼娜, 郭清华, 等. hCG和u-FSH序贯治疗低促性腺激素性腺功能减退症疗效和安全性评估[C]//中华医学会第十一次全国内分泌学学术会议论文汇编. 北京:中华医学会, 2012:155.
6. Topaloglu AK, Kotan LD. Molecular causes of hypogonadotropichypogonadism[J]. Curr Opin Obstet Gynecol, 2010, 22(4):264-270.
7. 郑郁. 促性腺激素释放激素兴奋试验对性发育疾病的诊断价值[D]. 天津:南开大学, 2012.
8. Yang L, Zhang SX, Dong Q, et al. Application of hormonal treatment in hypogonadotropic hypogonadism:more than ten years experience[J]. Int Urol Nephrol, 2012, 44(2):393-399.
9. Attia AM, Al-Inany HG, Proctor ML. Gonadotrophins for idiopathic male factor subfertility[J]. Cochrane Database Syst Rev, 2006, 17(1):CD005071.
10. Ishikawa T, Ooba T, Kondo Y, et al. Assessment of gonadotropin therapy in male hypogonadotropic hypogonadism[J]. Fertil Steril, 2007, 88(6):1697-1699.
11. 母义明, 李江源, 李永峰. 特发性低促性腺激素性性腺功能减退症患者黄体生成素脉冲分泌分析[J]. 中华内科杂志, 1995, 34(9):587-590.
12. 孙启虹, 窦京涛. 男性低促性腺激素性性腺功能减退的临床诊断及药物治疗[J]. 药品评价, 2013, 10(7):21-28.
13. Liu L, Banks SM, Barnes KM, et al. Two-year comparison of testicular responses to pulsatile gonadotropin-releasing hormone and exogenous gonadotropins from the inception of therapy in men with isolated hypogonadotropic hypogonadism[J]. J Clin Endocrinol Metab, 1988, 67(6):1140-1145.
14. Schopohl J, Mehltretter G, Von Zumbusch R, et al. Comparison of gonadotropin-releasing hormone and gonadotropin therapy in male patients with idiopathic hypothalamic hypogonadism[J]. Fertil Steril, 1991, 56(6):1143-1150.
15. Delemarre-Van de Waal HA. Induction of testicular growth and spermatogenesis by pulsatile, intravenous administration of gonadotrophin-releasing hormone in patients with hypogonadotrophic hypogonadism[J]. Clin Endocrinol (Oxf), 1993, 38(5):473-480.
16. Pitteloud N, Hayes FJ, Dwyer A, et al. Predictors of outcome of long-term GnRH therapy in men with idiopathic hypogonadotropic hypogonadism[J]. J Clin Endocrinol Metab, 2002, 87(9):4128-4136.
17. 孙首悦, 王卫庆, 王毅峰, 等. GnRH脉冲输注治疗低促性腺激素性发育不全症症[C]//中华医学会第二届糖尿病及性腺疾病学术会议论文集. 北京:中华医学会, 2012:20.
18. 金楠, 母义明. GnRH泵治疗低促性腺激素性性腺功能减退[J]. 药品评价, 2013, 10(7):10-13.
19. Christin-Maitre S, De Crécy M, Groupe Français des pompes à GnRH. Pregnancy outcomes following pulsatile GnRH treatment:results of a large multicenter retrospective study[J]. J Gynecol Obstet Biol Reprod (Paris), 2007, 36(1):8-12.

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Gonadotropin Releasing Hormone Pump in the Treatment of Hypogonadotropic Hypogonadism: A Report of One Case and the Literature Review

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