Secondary Treatment Failure without Anti‐human Chorionic Gonadotropin Antibody in a Patient with Kallmann Syndrome

A 29‐year‐old man with Kallmann syndrome suddenly developed decreased semen volume, azoospermia, and facial hair loss after 11 years of successful human chorionic gonadotropin (hCG) and human menopausal gonadotropin (hMG) treatment. Anti‐hCG antibody was not detected in the patient's serum. A h...

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Bibliographic Details
Published in:International journal of urology 1998-07, Vol.5 (4), p.398-400
Main Authors: Kitahara, Satoshi, Yoshida, Ken‐ichiro, Ishizaka, Kazuhiro, Higashi, Yotsuo, Takagi, Kentaro, Oshima, Hiroyuki
Format: Article
Language:English
Subjects:
Adult
Antibodies - blood
Antineoplastic Agents, Hormonal - administration & dosage
anti‐hCG antibody
Buserelin - administration & dosage
Chorionic Gonadotropin - administration & dosage
Chorionic Gonadotropin - immunology
Follicle Stimulating Hormone - blood
Gonadotropin-Releasing Hormone - agonists
hCG
Humans
hypogonadotropic hypogonadism
Kallmann Syndrome - drug therapy
Kallmann Syndrome - immunology
Luteinizing Hormone - blood
Male
Oligospermia - drug therapy
Oligospermia - immunology
secondary treatment failure
testosterone
Testosterone - administration & dosage
Testosterone - blood
Treatment Failure
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Summary:A 29‐year‐old man with Kallmann syndrome suddenly developed decreased semen volume, azoospermia, and facial hair loss after 11 years of successful human chorionic gonadotropin (hCG) and human menopausal gonadotropin (hMG) treatment. Anti‐hCG antibody was not detected in the patient's serum. A high serum level of luteinizing hormone (LH) with nasal LH‐releasing hormone analogue administration failed to increase serum testosterone to a sufficient level. Testosterone injection after cessation of hCG and hMG therapy was able to improve semen volume, but not azoospermia. Resumption of hCG and hMG therapy after 6 months cessation partially restored spermatogenesis. The secondary failure of hCG and hMG therapy suggests a decrease of testicular sensitivity to LH as well as hCG.
ISSN:0919-8172
1442-2042
DOI:10.1111/j.1442-2042.1998.tb00378.x