Normalisation of gonadotropin release by pump assisted pulsatile gonadotropin releasing hormone (GnRH) replacement in hypogonadotropic men. 1985

W D Hetzel, and T Sir-Petermann, and U Siebling, and E F Pfeiffer
Zentrum für Innere Medizin der Universität Ulm, Germany.

Pulsatile GnRH therapy is indicated for men with inborn hypothalamic hypogonadotropic hypogonadism and those with acquired gonadotropin deficiency due to hypothalamic disfunction. Oligospermia with hypothalamic GnRH deficiency is a rare indication for efficient GnRH therapy. Based on extended own experience and on the experience of numerous other groups, pulsatile GnRH therapy should be administered as follows: Onset of therapy should not start before the 16th year of age with clearly diagnosed delayed pubertal development. Subcutaneous administration of GnRH is preferred. The cannula should be changed every other day. Injection solutions should not contain Heparin. For diagnostic use or for inefficient subcutaneous therapy, continuation of intravenous therapy containing Heparin in the solution is recommended. The dosage should be measured on the increase of testosterone with stepwise increase of GnRH (25-200 ng/kg/pulse; 2.5-20 micrograms/pulse). As a pulse interval, 120 minutes appeared to be the most efficient, however 90 minutes of pulse intervals may also be efficient. The duration of therapy should be at least three months controlled on the testosterone level, the testes' volume and later on the sperm count.

UI MeSH Term Description Entries
D007006 Hypogonadism Condition resulting from deficient gonadal functions, such as GAMETOGENESIS and the production of GONADAL STEROID HORMONES. It is characterized by delay in GROWTH, germ cell maturation, and development of secondary sex characteristics. Hypogonadism can be due to a deficiency of GONADOTROPINS (hypogonadotropic hypogonadism) or due to primary gonadal failure (hypergonadotropic hypogonadism). Hypergonadotropic Hypogonadism,Hypogonadism, Isolated Hypogonadotropic,Hypogonadotropic Hypogonadism,Hypogonadism, Hypergonadotropic,Hypogonadism, Hypogonadotropic
D007260 Infusion Pumps Fluid propulsion systems driven mechanically, electrically, or osmotically that are used to inject (or infuse) over time agents into a patient or experimental animal; used routinely in hospitals to maintain a patent intravenous line, to administer antineoplastic agents and other drugs in thromboembolism, heart disease, diabetes mellitus (INSULIN INFUSION SYSTEMS is also available), and other disorders. Drug Infusion Systems,Infusion Pump,Infusion Pumps, External,Infusors,Intravenous Drug Delivery System,Intravenous Drug Delivery Systems,Perfusion Pumps,Pumps, Infusion,Drug Infusion System,External Infusion Pump,External Infusion Pumps,Infusion Pump, External,Infusion System, Drug,Infusion Systems, Drug,Infusor,Perfusion Pump,Pump, External Infusion,Pump, Infusion,Pump, Perfusion,Pumps, External Infusion,Pumps, Perfusion,System, Drug Infusion,Systems, Drug Infusion
D007986 Luteinizing Hormone A major gonadotropin secreted by the adenohypophysis (PITUITARY GLAND, ANTERIOR). Luteinizing hormone regulates steroid production by the interstitial cells of the TESTIS and the OVARY. The preovulatory LUTEINIZING HORMONE surge in females induces OVULATION, and subsequent LUTEINIZATION of the follicle. LUTEINIZING HORMONE consists of two noncovalently linked subunits, alpha and beta. Within a species, the alpha subunit is common in the three pituitary glycoprotein hormones (TSH, LH and FSH), but the beta subunit is unique and confers its biological specificity. ICSH (Interstitial Cell Stimulating Hormone),Interstitial Cell-Stimulating Hormone,LH (Luteinizing Hormone),Lutropin,Luteoziman,Luteozyman,Hormone, Interstitial Cell-Stimulating,Hormone, Luteinizing,Interstitial Cell Stimulating Hormone
D008297 Male Males
D010906 Pituitary Hormone-Releasing Hormones Peptides, natural or synthetic, that stimulate the release of PITUITARY HORMONES. They were first isolated from the extracts of the HYPOTHALAMUS; MEDIAN EMINENCE; PITUITARY STALK; and NEUROHYPOPHYSIS. In addition, some hypophysiotropic hormones control pituitary cell differentiation, cell proliferation, and hormone synthesis. Some can act on more than one pituitary hormone. Hormones, Pituitary Hormone Releasing,Hypophysiotropic Hormones,Hypothalamic Hypophysiotropic Hormone,Hypothalamic Releasing Factor,Hypothalamic Releasing Hormone,Hypothalamic Releasing Hormones,Hormone, Hypothalamic Hypophysiotropic,Hormones, Hypophysiotropic,Hypophysiotropic Hormone, Hypothalamic,Pituitary Hormone Releasing Hormones,Releasing Hormone, Hypothalamic
D005640 Follicle Stimulating Hormone A major gonadotropin secreted by the adenohypophysis (PITUITARY GLAND, ANTERIOR). Follicle-stimulating hormone stimulates GAMETOGENESIS and the supporting cells such as the ovarian GRANULOSA CELLS, the testicular SERTOLI CELLS, and LEYDIG CELLS. FSH consists of two noncovalently linked subunits, alpha and beta. Within a species, the alpha subunit is common in the three pituitary glycoprotein hormones (TSH, LH, and FSH), but the beta subunit is unique and confers its biological specificity. FSH (Follicle Stimulating Hormone),Follicle-Stimulating Hormone,Follitropin
D006065 Gonadotropins, Pituitary Hormones secreted by the adenohypophysis (PITUITARY GLAND, ANTERIOR) that stimulate gonadal functions in both males and females. They include FOLLICLE STIMULATING HORMONE that stimulates germ cell maturation (OOGENESIS; SPERMATOGENESIS), and LUTEINIZING HORMONE that stimulates the production of sex steroids (ESTROGENS; PROGESTERONE; ANDROGENS). Pituitary Gonadotropins
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D013739 Testosterone A potent androgenic steroid and major product secreted by the LEYDIG CELLS of the TESTIS. Its production is stimulated by LUTEINIZING HORMONE from the PITUITARY GLAND. In turn, testosterone exerts feedback control of the pituitary LH and FSH secretion. Depending on the tissues, testosterone can be further converted to DIHYDROTESTOSTERONE or ESTRADIOL. 17-beta-Hydroxy-4-Androsten-3-one,17-beta-Hydroxy-8 alpha-4-Androsten-3-one,8-Isotestosterone,AndroGel,Androderm,Andropatch,Androtop,Histerone,Sterotate,Sustanon,Testim,Testoderm,Testolin,Testopel,Testosterone Sulfate,17 beta Hydroxy 4 Androsten 3 one,17 beta Hydroxy 8 alpha 4 Androsten 3 one,8 Isotestosterone

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