A MALE CASE OF KALLMANN'S SYNDROME : FERTILITY INDUCED BY GONADOTROPIN (hCG/hMG) THERAPY

Abstract

A 24-year-old male patient with Kallmann's syndrome who fathered two children after gonadotropin therapy is reported here. He was diagnosed with Kallmann's syndrome because of hypothalamic hypogonadism associated with anosmia. The gonadotropin therapy was initiated which involved treatment with human chorionic gonadotropin (hCG) and human menopausal gonadotropin (hMG). After 3 years of treatment, his secondary sexual characteristics developed to near the adult level and sperm were detected in his semen. Although pulsatile luteinizing hormone releasing hormone (LH -RH) injection using a mini-pump was tried for 4 months, it did not maintain the plasma testosterone at normal levels. At 29 y the patient was switched to gonadotropin therapy. His sperm count reached 6×10(6/mm3, and his wife became pregnant ; they had a female baby. His second child was born when the patient was 32 y. The sequence of the KAL gene was normal in all 14 exons of the patient's DNA. Here we describe the clinical benefits of gonadotropin therapy and LH-RH therapy.