Gonadotropin replacement therapy in patients with hypogonadotropic hypogonadism

Patients with the syndrome of idiopathic hypogonadotropic hypogonadism (HH) are clinically characterized by the absence of sexual development, inability to achieve adult testicular size, and more or less severe impairment of germinal cell maturation in the testis. Lack of androgen secretion, secondary to impairment of gonadotropin release, accounts for the symptoms found. Deficiency of FSH and LH secretion in these patients is commonly due to the selective absence of hypothalamic GnRH release. Gonadotropin therapy has been found to achieve virilization and induction of spermatogenesis. The ultimate HH choice of treatment, of course, depends on many factors of which the patient's goal and wishes are foremost.