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.	伍學焱, 史軼蘩, 鄧潔英, 等. 大慶市健康男性青少年正常青春發育時間調查[J]. 中華醫學雜志, 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.	劉彥玲, 張曼娜, 郭清華, 等. hCG和u-FSH序貫治療低促性腺激素性腺功能減退癥療效和安全性評估[C]//中華醫學會第十一次全國內分泌學學術會議論文匯編. 北京:中華醫學會, 2012:155.
6.	Topaloglu AK, Kotan LD. Molecular causes of hypogonadotropichypogonadism[J]. Curr Opin Obstet Gynecol, 2010, 22(4):264-270.
7.	鄭郁. 促性腺激素釋放激素興奮試驗對性發育疾病的診斷價值[D]. 天津:南開大學, 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.	母義明, 李江源, 李永峰. 特發性低促性腺激素性性腺功能減退癥患者黃體生成素脈沖分泌分析[J]. 中華內科雜志, 1995, 34(9):587-590.
12.	孫啟虹, 竇京濤. 男性低促性腺激素性性腺功能減退的臨床診斷及藥物治療[J]. 藥品評價, 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.	孫首悅, 王衛慶, 王毅峰, 等. GnRH脈沖輸注治療低促性腺激素性發育不全癥癥[C]//中華醫學會第二屆糖尿病及性腺疾病學術會議論文集. 北京:中華醫學會, 2012:20.
18.	金楠, 母義明. GnRH泵治療低促性腺激素性性腺功能減退[J]. 藥品評價, 2013, 10(7):10-13.
19.	Christin-Maitre S, De Crécy M, Groupe Fran?ais 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. 伍學焱, 史軼蘩, 鄧潔英, 等. 大慶市健康男性青少年正常青春發育時間調查[J]. 中華醫學雜志, 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. 劉彥玲, 張曼娜, 郭清華, 等. hCG和u-FSH序貫治療低促性腺激素性腺功能減退癥療效和安全性評估[C]//中華醫學會第十一次全國內分泌學學術會議論文匯編. 北京:中華醫學會, 2012:155.
6. Topaloglu AK, Kotan LD. Molecular causes of hypogonadotropichypogonadism[J]. Curr Opin Obstet Gynecol, 2010, 22(4):264-270.
7. 鄭郁. 促性腺激素釋放激素興奮試驗對性發育疾病的診斷價值[D]. 天津:南開大學, 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. 母義明, 李江源, 李永峰. 特發性低促性腺激素性性腺功能減退癥患者黃體生成素脈沖分泌分析[J]. 中華內科雜志, 1995, 34(9):587-590.
12. 孫啟虹, 竇京濤. 男性低促性腺激素性性腺功能減退的臨床診斷及藥物治療[J]. 藥品評價, 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. 孫首悅, 王衛慶, 王毅峰, 等. GnRH脈沖輸注治療低促性腺激素性發育不全癥癥[C]//中華醫學會第二屆糖尿病及性腺疾病學術會議論文集. 北京:中華醫學會, 2012:20.
18. 金楠, 母義明. GnRH泵治療低促性腺激素性性腺功能減退[J]. 藥品評價, 2013, 10(7):10-13.
19. Christin-Maitre S, De Crécy M, Groupe Fran?ais 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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