Spermatogenesis of Male Patients with Congenital Hypogonadotropic Hypogonadism Receiving Pulsatile Gonadotropin-Releasing Hormone Therapy Versus Gonadotropin Therapy: A Systematic Review and Meta-Analysis
Purpose: Pulsatile gonadotropin-releasing hormone (GnRH) therapy and gonadotropin therapy (GT) were widely used for male patients with congenital hypogonadotropic hypogonadism (CHH), but their efficacy was not well compared before. We conducted this meta-analysis to compare the efficacy of restori...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Korean Society for Sexual Medicine and Andrology
2021-10-01
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| Series: | The World Journal of Men's Health |
| Subjects: |
| _version_ | 1818882391302733824 |
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| author | Chao Wei Gongwei Long Yucong Zhang Tao Wang Shaogang Wang Jihong Liu Delin Ma Xiaming Liu |
| author_facet | Chao Wei Gongwei Long Yucong Zhang Tao Wang Shaogang Wang Jihong Liu Delin Ma Xiaming Liu |
| author_sort | Chao Wei |
| collection | DOAJ |
| description | Purpose: Pulsatile gonadotropin-releasing hormone (GnRH) therapy and gonadotropin therapy (GT) were widely used for
male patients with congenital hypogonadotropic hypogonadism (CHH), but their efficacy was not well compared before. We
conducted this meta-analysis to compare the efficacy of restoring fertility using these two therapies.
Materials and Methods: PubMed, Web of Science, and Scopus were systematically searched for comparative studies evaluating
the efficiency of GnRH therapy and GT for male patients with CHH. For continuous outcomes, the weighted mean difference
(WMD) was used to measure the difference, whereas the risk ratio with 95% confidence interval was calculated for
binary variables.
Results: Overall, eight articles from seven studies with 420 patients enrolled were included in the analysis. Patients from the
two different groups were determined to be comparable in age, proportion with Kallmann syndrome, percentage of cryptorchidism
and pretreatment hormones (follicular-stimulating hormone, luteinizing hormone, and testosterone). GnRH therapy
was related to a larger testicular volume (standardized mean difference=-1.43; p=0.01) and earlier spermatogenesis (WMD=-
5.30 months; p=0.004) compared to GT. However, the difference in the rate of positive sperm detection (p=0.08), sperm
concentration (p=0.37), and pregnancy rate (p=0.11) were not significant. Allergic reactions mostly occurred during GnRH
therapy, while GT was related to a higher incidence of gynecomastia and acne.
Conclusions: Compared to GT, GnRH was related to earlier spermatogenesis and less estradiol-related adverse reactions, although
there were no significant differences in spermatogenesis rate, sperm concentration, and pregnancy rate. High-quality
randomized controlled trials are needed for future research. |
| first_indexed | 2024-12-19T15:17:01Z |
| format | Article |
| id | doaj.art-c3f4bd84a1184255b8131f13df43c683 |
| institution | Directory Open Access Journal |
| issn | 2287-4208 2287-4690 |
| language | English |
| last_indexed | 2024-12-19T15:17:01Z |
| publishDate | 2021-10-01 |
| publisher | Korean Society for Sexual Medicine and Andrology |
| record_format | Article |
| series | The World Journal of Men's Health |
| spelling | doaj.art-c3f4bd84a1184255b8131f13df43c6832022-12-21T20:16:07ZengKorean Society for Sexual Medicine and AndrologyThe World Journal of Men's Health2287-42082287-46902021-10-0139465466510.5534/wjmh.200043Spermatogenesis of Male Patients with Congenital Hypogonadotropic Hypogonadism Receiving Pulsatile Gonadotropin-Releasing Hormone Therapy Versus Gonadotropin Therapy: A Systematic Review and Meta-AnalysisChao Wei0https://orcid.org/0000-0001-9205-5030Gongwei Long1https://orcid.org/0000-0001-8008-2306Yucong Zhang2https://orcid.org/0000-0002-2991-5066Tao Wang3https://orcid.org/0000-0002-2614-4913Shaogang Wang4https://orcid.org/0000-0003-0211-4303Jihong Liu5https://orcid.org/0000-0002-3649-9734Delin Ma6https://orcid.org/0000-0002-0860-0129Xiaming Liu7https://orcid.org/0000-0002-1194-8791Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaTongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaTongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaTongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaTongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaTongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaTongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaTongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaPurpose: Pulsatile gonadotropin-releasing hormone (GnRH) therapy and gonadotropin therapy (GT) were widely used for male patients with congenital hypogonadotropic hypogonadism (CHH), but their efficacy was not well compared before. We conducted this meta-analysis to compare the efficacy of restoring fertility using these two therapies. Materials and Methods: PubMed, Web of Science, and Scopus were systematically searched for comparative studies evaluating the efficiency of GnRH therapy and GT for male patients with CHH. For continuous outcomes, the weighted mean difference (WMD) was used to measure the difference, whereas the risk ratio with 95% confidence interval was calculated for binary variables. Results: Overall, eight articles from seven studies with 420 patients enrolled were included in the analysis. Patients from the two different groups were determined to be comparable in age, proportion with Kallmann syndrome, percentage of cryptorchidism and pretreatment hormones (follicular-stimulating hormone, luteinizing hormone, and testosterone). GnRH therapy was related to a larger testicular volume (standardized mean difference=-1.43; p=0.01) and earlier spermatogenesis (WMD=- 5.30 months; p=0.004) compared to GT. However, the difference in the rate of positive sperm detection (p=0.08), sperm concentration (p=0.37), and pregnancy rate (p=0.11) were not significant. Allergic reactions mostly occurred during GnRH therapy, while GT was related to a higher incidence of gynecomastia and acne. Conclusions: Compared to GT, GnRH was related to earlier spermatogenesis and less estradiol-related adverse reactions, although there were no significant differences in spermatogenesis rate, sperm concentration, and pregnancy rate. High-quality randomized controlled trials are needed for future research.chorionic gonadotropingonadotropin-releasing hormoneidiopathic hypogonadotropic hypogonadismkallmann syndromespermatogenesis |
| spellingShingle | Chao Wei Gongwei Long Yucong Zhang Tao Wang Shaogang Wang Jihong Liu Delin Ma Xiaming Liu Spermatogenesis of Male Patients with Congenital Hypogonadotropic Hypogonadism Receiving Pulsatile Gonadotropin-Releasing Hormone Therapy Versus Gonadotropin Therapy: A Systematic Review and Meta-Analysis The World Journal of Men's Health chorionic gonadotropin gonadotropin-releasing hormone idiopathic hypogonadotropic hypogonadism kallmann syndrome spermatogenesis |
| title | Spermatogenesis of Male Patients with Congenital Hypogonadotropic Hypogonadism Receiving Pulsatile Gonadotropin-Releasing Hormone Therapy Versus Gonadotropin Therapy: A Systematic Review and Meta-Analysis |
| title_full | Spermatogenesis of Male Patients with Congenital Hypogonadotropic Hypogonadism Receiving Pulsatile Gonadotropin-Releasing Hormone Therapy Versus Gonadotropin Therapy: A Systematic Review and Meta-Analysis |
| title_fullStr | Spermatogenesis of Male Patients with Congenital Hypogonadotropic Hypogonadism Receiving Pulsatile Gonadotropin-Releasing Hormone Therapy Versus Gonadotropin Therapy: A Systematic Review and Meta-Analysis |
| title_full_unstemmed | Spermatogenesis of Male Patients with Congenital Hypogonadotropic Hypogonadism Receiving Pulsatile Gonadotropin-Releasing Hormone Therapy Versus Gonadotropin Therapy: A Systematic Review and Meta-Analysis |
| title_short | Spermatogenesis of Male Patients with Congenital Hypogonadotropic Hypogonadism Receiving Pulsatile Gonadotropin-Releasing Hormone Therapy Versus Gonadotropin Therapy: A Systematic Review and Meta-Analysis |
| title_sort | spermatogenesis of male patients with congenital hypogonadotropic hypogonadism receiving pulsatile gonadotropin releasing hormone therapy versus gonadotropin therapy a systematic review and meta analysis |
| topic | chorionic gonadotropin gonadotropin-releasing hormone idiopathic hypogonadotropic hypogonadism kallmann syndrome spermatogenesis |
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