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Hypergonadotropic Hypogonadism: Management of Infertility. | LitMetric
Background : Medical treatments are used either alone or in combination with assisted reproductive techniques for the treatment of infertile patients with hypergonadotropic hypogonadism. A wide range of treatment options such as gonadotropins, aromatase inhibitors (AIs), selective estrogen receptor modulators (SERMs) and their combination are available as options.Objective : The aim of this review was to evaluate treatment options for infertile men with hypergonadotropic hypogonadism.Methods : A literature search of MEDLINE (1980-2019) was conducted using the terms 'hypogonadism', 'male infertility', 'gonadotropins', 'SERMs' and 'AIs'. Pathologies leading to hypergonadotropic hypogonadism and treatment modalities such as gonadotropins, SERMs, AIs and surgical treatment were discussed.Results : FSH increases spontaneous pregnancy rates but the level of evidence was proven to be low for live birth rates. AIs are valid treatment options for patients with low T/E2 ratio as they significantly increase sperm concentrations. SERMs are recommended for infertile males with a sperm concentration between 10-20 million. Varicocele was reported to increase testosterone levels of hypogonadic infertile males.Conclusion : Medical treatment modalities such as gonadotropins, SERMs, AIs and a combination of these therapies has been showed to have some effect in improvement of fertility but is not mainstream of the treatment.
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