Semin Reprod Med 2013; 31(04): 237-244
DOI: 10.1055/s-0033-1345270
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Male Reproductive Endocrinology: When to Replace Gonadotropins

J. C. Trussell
1   Division of Male Fertility and Sexual Function, Department of Urology, Upstate University Hospital, Syracuse, New York
› Author Affiliations
Further Information

Publication History

Publication Date:
17 June 2013 (online)

Abstract

Infertility is generally defined as a couple's inability to conceive after 1 year of unprotected intercourse. When infertile couples seek assistance, a male factor will be identified half of the time. Once the male has been evaluated, there are four main categories to describe his infertility: (1) idiopathic, (2) post-testicular/obstructive, (3) primary—where the Sertoli and/or Leydig cells of the testis fail, and (4) secondary—where there is a problem with the hypothalamus and/or pituitary. The last, hypogonadotropic hypogonadism (HH), accounts for up to 2% of infertile men. HH is either congenital or acquired and usually can be successfully treated by medical intervention. This review will focus on the hypothalamus–pituitary–gonadal axis, specific defects of this coordination center, and potential interventions for improving male-factor fertility.

 
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