Male hypogonadism is a clinical syndrome resulting from decreased production of testosterone (T4), sperm, or both, and can be caused by congenital or acquired disorders. Depending on the cause, hypogonadism is classified as primary or secondary.
Primary hypogonadism is caused by testicular disease and results in low T4 concentration, impaired spermatogenesis, and high gonadotropin concentrations. Secondary hypogonadism is caused by a dysfunction of the hypothalamic-pituitary axis and results in low T4 concentration, decreased spermatogenesis, and low gonadotropin concentrations.
In primary hypogonadism, spermatogenesis is impaired more than T4 production, while in secondary hypogonadism, both functions are equally affected.
Treatment of hypogonadism usually depends on the type. Primary hypogonadism does not respond to hormonal therapy due to damage to the seminiferous tubules; therefore, artificial insemination, donor sperm, and adoption should be considered instead.
In patients with secondary hypogonadism, fertility can be restored with GnRH or gonadotropin therapy.
Furthermore, the use of human chorionic gonadotropin or FSH in patients with hypogonadism can lead to testicular enlargement. In mammals, the use of FSH can increase the number of stem cells.
