Success in gaining pregnancy in people with hypogonadotrophic hypogonadism using human chorionic gonadotrophin (HCG) and human menopausal gonadotrophin (HMG)

Sarah Revesz
Department of Endocrinology, Royal Devon and Exeter Hospital, Exeter, UK.

Endocrine Nurses Training Course 2005, John MacIntyre Centre, The University of Edinburgh, 18 Holyrood Park Road, Edinburgh EH16 5AY, UK
30 August - 1 September 2005

CASE 1
A 35-year-old man was diagnosed with acromegaly in 1995. He has undergone two hypophysectomies and was found to be panhypopituitary following radiotherapy in 1998. He was subsequently commenced on hydrocortisone, thyroxine and testosterone replacement. In December 2000, this couple wanted to start a family. His sperm count was found to be < 1 million and sluggish. In March 2001, no sperm were seen and he was commenced on HCG 2000iu three times a week. His wife did fall pregnant following this but miscarried in August 2002. In November 2002, due to no further conception despite treatment with HCG, HMG 75units three times a week was added. In February 2003, his wife became pregnant again and a baby boy was born. Currently they are attempting to conceive again.

CASE 2
A 36-year-old man was diagnosed at the age of 18 with isolated gonadotrophin deficiency. He had been treated with oral testosterone 40mg daily. In March 1997 he presented to the endocrine service, complaining of poor virilisation and requesting fertility treatment. He was commenced on HCG 4000iu three times a week. This dose was decreased to 2500iu to keep his testosterone in the normal range. By October, although well virilised and with normal testosterone levels, his sperm count was 0. HMG 75iu three times a week was added. In January 1998, some sperm were seen and by the spring his wife was pregnant. A baby boy was delivered late that year.

Conclusion
These two cases demonstrate that using HCG and HMG can result in successful pregnancy in people with hypogonadotrophic hypogonadism.

Revised: 16-Sep-2005