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Male Sexual Dysfunction and Male Factor Infertility
Published in Karl H. Pang, Nadir I. Osman, James W.F. Catto, Christopher R. Chapple, Basic Urological Sciences, 2021
Hypogonadotropic hypogonadism:Primary abnormality of the pituitary or hypothalamus.Low levels of LH (and usually FSH).Testicular insufficiency with low testosterone (Table 22.3).Oligozoospermia or azoospermia.
Principles of Pathophysiology of Infertility Assessment and Treatment*
Published in Asim Kurjak, Ultrasound and Infertility, 2020
Joseph G. Schenker, Aby Lewin, Menashe Ben-David
The examination of ejaculate is undertaken with regard to morphological, biochemical, and vitality aspects (Figure 8). Approximately 20% of infertile males are azoospermic. Azoospermia may be due to spermatogenic failure, obstruction of any level of the genital tract, or retrograde ejaculation. The algorithmic approach to the evaluation and treatment of the azoospermic male is shown in Figure 10. In most azoospermic males, there is little hope of restoring normal spermatogenesis. Only in cases of hypogonadotrophic hypogonadism was fertility achieved following administration of HMG-HCG therapy and more recently following application of Gn-RH analogs. Cryptorchidism is a potentially preventable cause of infertility, if the testis is brought into the scrotum early in life. When the epididimis or vas has become obstructed because of veneral disease, tuberculosis, or after acute nonspecific epididimitis, the obstruction can often by surgically corrected in about 40 to 50% of the cases. Pregnancies in cases of retrograde ejaculation were obtained following pharmacological therapy or recovery of sperm from the urinary bladder.
Female Methods
Published in Sujoy K. Guba, Bioengineering in Reproductive Medicine, 2020
In properly selected patients pulsatile GnRH infusion leads to increase in serum LH and FSH and the levels of these hormones exhibit a pulsatile character44 as is shown in Figure 11.19. Actual ovulation induction is more difficult to assess. Knowledge and experience in this area of therapy is still growing and success rates, as judged on the basis of pregnancies, is likely to improve. Currently very good outcomes are seen in cases of hypogonadotrophic hypogonadism and this abnormality is one of the principal indications of the therapy. At the other extreme, results in cases of idiopathic oligomenorrhea is quite poor.
Factors of mineral homeostasis impairment and bone mineral density loss in women with central hypogonadism
Published in Climacteric, 2020
I. Ilovayskaya, V. Zektser, L. Lazebnik
One of the causes of hypoestrogenism in young women is central (hypogonadotropic) hypogonadism. Central hypogonadism (CH) may be congenital or acquired. Congenital causes include Kallmann syndrome and idiopathic hypogonadotropic hypogonadism. Acquired organic causes include pituitary lesions and the consequences of their surgical/radiation treatment, ischemic pituitary necrosis, primary ‘empty sella’ syndrome, and systemic infiltrative diseases such as sarcoidosis and hemochromatosis. Exercise or weight loss induce acquired functional hypothalamic dysfunction in women without organic damage of the hypothalamic–hypophyseal region (so-called functional hypothalamic amenorrhea). Regardless of the cause, the physiological result for the patient will be gonadotropic deficiency.
The evaluation of ovarian function in normosmic idiopathic hypogonadotropic hypogonadism with a fibroblast growth factor receptor 1 mutation: a case report
Published in Gynecological Endocrinology, 2022
The etiology and pathogenesis of IHH are not fully understood. IHH is a genetically heterogeneous condition that can be sporadic or familial. In the last decade, major advances have been made in unraveling the genetic basis for IHH. To date, mutations have been identified in approximately 40% of IHH patients [5]. Mutations in at least two dozen genes cause hypogonadotropic hypogonadism. Genes underlying IHH have been shown to be critical for the specification and proliferation of GnRH neurons, their migration to the hypothalamus, and the regulation of GnRH secretion. Other patterns of inheritance have been identified, including x-linked recessive inheritance, autosomal recessive inheritance, and autosomal dominant inheritance [6,7].
Hypogonadism and associated risk factors in male patients with type 2 diabetes mellitus attending the diabetic clinic of Tikur Anbessa Specialized Teaching Hospital, Addis Ababa, Ethiopia
Published in Journal of Endocrinology, Metabolism and Diabetes of South Africa, 2019
Sisay Teka, Samuel Kinde, Gobena Dedefo, Kissi Mudi, Getahun Tarekegn
Hypogonadism was classified as primary (hypergonadotropic) and secondary (hypogonadotropic) hypogonadism. Primary hypogonadism, which is caused by testicular failure, is characterised by high luteinising (LH) and follicle stimulating hormone (FSH) concentrations whereas secondary hypogonadism, which is caused by the defect in the hypothalamus or pituitary gland, is characterised by low or low-normal FSH and LH. Both types of hypogonadism were observed in men with T2DM. However, secondary hypogonadism was the most prevalent among these men with a prevalence range of 25–40%.2,4