Effects of preceding androgen therapy on testicular response to human pituitary gonadotropin in hypogonadotropic hypogonadism: a study of three patients.

There is some uncertainty about the choice of initial therapy to induce virilization in men with hypogonadotropic hypogonadism (HH) who may subsequently desire fertility. Three patients with HH and azoospermia are described. All had received long-term androgen therapy in fully virilizing doses, and two also received interval androgen therapy. Spermatogenesis occurred in all three patients after treatment with human chorionic gonadotropin and human pituitary gonadotropin, and the wives of all three conceived. For two patients conception occurred three times in response to gonadotropin therapy, and libido and potency were maintained with testosterone between each conception. It is concluded that preceding long-term therapeutic doses of androgen do not impair subsequent induction of spermatogenesis in patients with HH.