Patient selection: male with hypogonadotrophic hypogonadism with azoospermia or aspermia from 18 to 45 years of age
Injection of purified FSH and HCG (which provides LH activity) takes some time to be effective so monitoring should be over the year after starting although some patients may show an early improvement.
Responses to therapy:
(1) sperm count
(2) change in male physical findings
change in sperm count =
= (sperm count after therapy) – (sperm count before starting therapy)
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Sperm Count
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Response
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no change
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nonresponder
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an increase but count less than 1 M per mL sperm
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partial response
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>= 1 M per mL
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complete respoonse
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A person who responds will have:
(1) an increase ejaculate volume
(2) an increase in penis length
(3) increase in Tanner stage for male hair distribution (from prepubertal)
(4) increase in serum testosterone to the normal range
(5) increase in testicular volume
Failure to respond:
(1) poor compliance
(2) delayed but eventual response
(3) wrong diagnosis
