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Fertility Potential of Patients with Hypogonadotropic Hypogonadism

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Clues in the Diagnosis of Non-tumoral Testicular Pathology

Abstract

Hypogonadotropic hypogonadism, regardless of its etiology, is one of the causes of male infertility which can benefit from medical treatment. Treatment of patients with idiopathic hypogonadotropic hypogonadism (IHH) with physiological pulsatile GnRH has shown that approximately 25 % of patients do not respond as expected with normalization of testosterone gonadotropins and spermatogenesis. In some cases, the cause of the absence of response would be a pituitary resistance to GnRH, while in the remaining cases, a dual anomaly of both GnRH deficiency and testicular failure either in Leydig cells or in the seminiferous tubules is suggested. Unfortunately, histological studies in these patients are scarce. It is necessary to address the hypogonadotropic hypogonadisms from different points of view, not only the genetic, the molecular biology, and the clinical view but also the histopathological view if we want to predict with greater certainty the results after treatment, both hormonal recovery and sperm formation. Histological study of testicular parenchyma is the only method that can report the presence or absence of germ cells and the degree of renewal of these cells, two key facts to the induction of spermatogenesis that could be effective. The chapter is divided into four parts: (1) summary of the development and physiology of the reproductive axis, (2) etiology of hypogonadotropic hypogonadism, (3) fertility predictive data, and (4) most indicated therapeutic lines.

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Authors and Affiliations

  1. Universidad Autónoma de Madrid (UAM), Department of Anatomy, Histology and Neuroscience, School of Medicine, Madrid, Spain

    Manuel Nistal

  2. School of Medicine, Universidad Autónoma de Madrid (UAM), University Hospital La Paz, Department of Pathology, Madrid, Spain

    Pilar González-Peramato

  3. University Hospital Clinico San Carlos, Department of Urology, Madrid, Spain

    Álvaro Serrano

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  1. Manuel Nistal
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  2. Pilar González-Peramato
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  3. Álvaro Serrano
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Correspondence to Manuel Nistal .

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Nistal, M., González-Peramato, P., Serrano, Á. (2017). Fertility Potential of Patients with Hypogonadotropic Hypogonadism. In: Clues in the Diagnosis of Non-tumoral Testicular Pathology. Springer, Cham. https://doi.org/10.1007/978-3-319-49364-0_19

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  • DOI: https://doi.org/10.1007/978-3-319-49364-0_19

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  • Print ISBN: 978-3-319-49363-3

  • Online ISBN: 978-3-319-49364-0

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