Purpose

We compared our clinical experience to international standards, assessed by response to treatment and pregnancy rates to ensure our results were comparable.

Methods

Men presenting with azoospermia related to hypogonadism were recruited into a treatment programme which was managed by one person over 8 years in a secondary care facility. Treatment followed published management plans using urinary gonadotropins. Data were collected on success rates in spermatogenesis, as well as variables which might predict success, and costs. Statistical analysis used non-parametric methods.

Results

Of 16 men with HH, 14 achieved spermatogenesis, and 9 had sperm cryopreserved. Of those 14, 6 were successful in achieving a pregnancy with their partner from assisted conception (including ICSI) and one after natural conception. Factors identified to identify men likely to be successful in treatment were whether testicular volume was larger at onset of gonadotropins (median 10 mL) with a trend towards greater success if the cause developed after puberty. Mean treatment costs per man treated amounted to GP£4379/UD$5377 (figures for September 2020).

Summary

Success rates from this treatment should exceed 70% in most clinical settings. The likelihood of success improves when testicular volume exceeded 10 mL at initiation of treatment and a trend exists whereby success is more likely whereby when hypogonadism developed after puberty. Treatment costs are at a level likely to benefit quality of life, supporting the delivery of this treatment and where necessary and possible, funding it in line with other fertility treatments. This treatment should be available much more widely as a management option for men with hypogonadism, allowing them to father a biological child, rather than using donor sperm.

中文翻译：

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诱导患有低促性腺激素性性腺功能减退症的男性的精子发生

目的

我们将我们的临床经验与国际标准进行比较，通过治疗反应和妊娠率进行评估，以确保我们的结果具有可比性。

方法

患有与性腺功能减退症相关的无精子症的男性被招募到一个治疗计划中，该计划由一名在二级护理机构工作了 8 年多的人负责管理。治疗遵循已发布的使用尿促性腺激素的管理计划。收集了有关精子发生成功率的数据，以及可能预测成功的变量和成本。统计分析采用非参数方法。

结果

16 名 HH 男性中，14 名实现了精子发生，9 名精子被冷冻保存。在这 14 人中，6 人通过辅助受孕（包括 ICSI）成功与伴侣怀孕，1 人在自然受孕后成功怀孕。确定男性治疗可能成功的因素是促性腺激素开始使用时睾丸体积是否较大（中位数 10 毫升），如果原因在青春期后出现，则有取得更大成功的趋势。每名接受治疗的人的平均治疗费用为 4379 英镑/5377 美元（2020 年 9 月的数字）。

概括

在大多数临床环境中，这种治疗的成功率应超过 70%。当治疗开始时睾丸体积超过 10 mL 时，成功的可能性会提高，并且存在一种趋势，即青春期后出现性腺功能减退症时，成功的可能性更大。治疗费用处于可能有利于生活质量的水平，支持这种治疗的实施，并在必要和可能的情况下，与其他生育治疗一起为其提供资金。这种治疗应该作为性腺功能减退症男性的一种治疗选择得到更广泛的应用，让他们能够生育亲生孩子，而不是使用捐赠的精子。