Evaluation of demographic features, radiologic and laboratory parameters in male patients with hypogonadotrophic hypogonadism

Introduction: Hypogonadotrophic hypogonadism is a pathology of hypothalamus and/or anterior hyphophysis characterised with insufficient secretion of LH and FSH. In hypergonadotrophic hypogonadism, fertility can not be achievable with treatment, in contrast patients with hypogonadotrophic hypogonadism have chance of being fertile with appropriate management. New parameters in patients with hypogonadotrophic hypogonadism should be defined for better management and follow-up as well as for fertility chance and preventing long-term complications of disease. In this retrospective study, we aim to determine the parameters that can be applicable for effective management and follow-up after diagnosis. Material and Method: 55 (age between 16 to 50) male patients with hypogonadism diagnosed between period of 2009 and 2015 were included in this study. Patients with panhypopituitarism, primary hypogonadotrophic hypogonadism, comorbid conditions and hypogonadism secondary to malignancy management were excluded from the study. Age, height, weight, CBC, liver fucntion tests (AST, ALT), urea, creatine, glucose, cholesterol, LH, FSH, prolactin, ACTH, cortisol and testosteron levels were evaluated. Patients testosteron levels, spermiogram and testicular volume before and after treatment were determined.. Results: Demographic information of 30 patients can be found. In these patients, mean body mass index (BMI) was 26,2 ± 3,87 (kg/m²). The average of height was 177,9 ± 7,6 cm. The average weigth was 83,3 ± 12,8 kg. Among these patients, only 15 were married and %53,3 of these have children. Testosteron levels of 55 patients can be found and among these, treatment showed significant increase in average testosteron levels (B.T.: 0,88 ± 1,3 (ng/ml) , A.T.: 5,98 ± 2,96 (ng/ml) (p:0,001). Sperm count showed statistically significant increase after treatment (B.T.: 4,87 ± 15,24 milyon/ml, A.T.: 10,36 ± 23,72 milyon/ml)(p:0,004). 15 of all patients can be compared for testicular volume. Mean right and left testis volume showed statistically significant increase after treatment.(Rigt testis B.T: 4,64±4,89 mm³, A.T.: 6,64 ± 4,75 mm³; left testis B.T.: 4,67 ± 5,00 mm³, A.T: 7,04±4,32 mm³ (p<0,05). It was found that testosteron levels and testicular volume before and after treament are correlated.(right r:0,516, left r:0,460 p<0,05). Additionally, it was detected that sperm morphology and testicular volume before and after treatment are correlated.(p<0,05). It was found that increase in testicular volume after treament is associated with increase in sperm counts in spermiogram analysis.(right testis r:0,716 p<0,005, left testis r:0,711 p:<0,05). Conclusion: Testosteron levels and testicular volume of patients are increased with treatment. In addition, sperm concentration also shows valuable increase. Testicular volume improvement is associated with initial levels of testosteron.