Comparison of therapeutic response to gonadotropin therapy between chinese male adolescents and young adults with hypogonadotropic hypogonadism caused by pituitary stalk interruption.

Hypogonadotropic hypogonadism (HH) is common in pituitary stalk interruption (PSI) patients. However, the optimal timing and effective regimen in the management of the pituitary-gonadal axis deficiency is still controversial. This study involved a retrospective review of 38 male patients with HH resulting from PSI. The HH patients were subdivided according to their ages into 2 experiment groups: Group I (adolescents, 14-18 years old, 25 cases) and Group II (young adults, 18-24 years old, 13 cases). To compare the therapeutic response to exogenous gonadotropin, a control analysis was carried out in the experimental groups with age-matched control groups. Before gonadotropin therapy, no significant increases in gonadal hormones were noted in either of the 2 experimental groups. After treatment with human chorionic gonadotropin (hCG) for less than 6 months, the hormone levels of pituitary-gonadal axis significantly increased in group I than in group II. After adding the human menopause gonadotropin (hMG) for 6 months, the gonadal hormone levels of group II were significantly increased. In addition, the Tanner stage and penis lengths in group I were significantly improved. There was no significant adverse impact on BMI and height velocity (HV) after less than one year therapy. A prolonged hypogonadotropic period without treatment may be responsible for testicular dysfunction in HH males caused by PSI. Early supplementary therapy with hCG and hMG is beneficial for the recovery of gonadal hormone and development of secondary sexual characteristics.