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This study will evaluate the efficacy and safety of long term use of hCG alone or hCG plus hMG in the treatment of male patients with isolated hypogonadotropic hypogonadism (IHH). One third of the participants will receive hCG treatment alone and the other third of the participants will receive hCG treatment alone for six months, then the hMG will be added. And the last third of the participants will receive hCG and hMG treatment since the beginning of the treatment.
The efficacy of hCG alone or hCG plus hMG in the treatment of male IHH patients was reported in some studies. However, these studies were mostly non-randomized controlled studies with small size of samples and short follow-up time. There was also no reported study which aimed to compare the efficacy and safety of long term use of hCG or hCG plus hMG in the treatment of male patients with IHH. So the difference in the efficacy and safety between long term use of hCG alone and hCG plus hMG in the treatment of IHH is unknown. In different reported studies, the hCG plus hMG treatment had two regimens: using hCG alone for six month, then hMG was added and using hCG plus hMG since the beginning of the treatment. The difference in the efficacy and safety between the above two regimes is also unknown.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Human Chorionic Gonadotropin alone | Active Comparator | Human Chorionic Gonadotropin 2000U~6000U, intramuscular injection, two times per week for 3 years. |
|
| hCG alone for 6 months then hMG added | Experimental | Human Chorionic Gonadotropin 2000U~6000U, intramuscular injection, two times per week for six months, then 75~150IU human menopausal gonadotropin, intramuscular injection, two times per week, was added and last for the next 30 months. |
|
| hCG and hMG | Experimental | Human Chorionic Gonadotropin 2000U~6000U and 75~150IU human menopausal gonadotropin, intramuscular injection, two times per week for 3 years. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Human Chorionic Gonadotropin | Drug | White freeze-dried cake or powder with specifications of 1000U, 2000U, 5000U. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Sperm density | Sperm density will be obtained in the semen sample analysis using the World Health Organization (WHO) normal values based on the WHO 2010 reference limits. | 6 months. |
| Measure | Description | Time Frame |
|---|---|---|
| Semen volume | Sperm volume will be obtained in the semen sample analysis using the World Health Organization (WHO) normal values based on the WHO 2010 reference limits. | 6 months. |
| Sperm activity |
| Measure | Description | Time Frame |
|---|---|---|
| Height | Height will be measured at every visit. | 3 months. |
| Weight | Weight will be measured at every visit. | 3 months. |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Hao Xu, M.D | Contact | +86-15872427301 | haoxutjmu@163.com | |
| Yinwei Chen, M.D | Contact | +86-15527953877 | 913904361@qq.com |
| Name | Affiliation | Role |
|---|---|---|
| Jihong Liu, M.D | Departments of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology | Recruiting | Wuhan | Hubei | 430030 | China |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 22763096 | Background | Zacharin M, Sabin MA, Nair VV, Dabadghao P. Addition of recombinant follicle-stimulating hormone to human chorionic gonadotropin treatment in adolescents and young adults with hypogonadotropic hypogonadism promotes normal testicular growth and may promote early spermatogenesis. Fertil Steril. 2012 Oct;98(4):836-42. doi: 10.1016/j.fertnstert.2012.06.022. Epub 2012 Jul 3. | |
| 18930190 |
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De-identified individual participant data for all primary and secondary outcome measure will be available.
Data will be available with 6 months of study completion.
Data access requests will be reviewed by the external independent review panel and Tongji hospital. Requester will be reqiured to sign a Data Acces Agreement.
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|
| human menopausal gonadotropin | Drug | White freeze-dried cake or powder with specification of 75IU. |
|
|
Sperm activity will be obtained in the semen sample analysis using the World Health Organization (WHO) normal values based on the WHO 2010 reference limits.
| 6 months. |
| The time for sperm to appear during treatment | The time for the sperm firstly appeared in the semen will be recorded. | 6 months. |
| Serum testosterone levels | The serum testosterone levels will be tested in every visit. | 3 months. |
| Testicular volume | Testicular volume will be measured using a Prader orchidometer. | 3 months. |
| Penis length | Penis length will be measured from the pubic symphysis to glans using a vernier caliper. | 3 months. |
| Pubic hair | Pubic hair will be evaluated according to Tanner pubertal stages. | 3 months. |
| Genitalia | Genitalia will be evaluated according to Tanner pubertal stages. | 3 months. |
| Feeling of inferiority scale score | Feeling of inferiority scale scores will be obtained using feeling of inferiority scale. | 3 months. |
| Background |
| Matsumoto AM, Snyder PJ, Bhasin S, Martin K, Weber T, Winters S, Spratt D, Brentzel J, O'Dea L. Stimulation of spermatogenesis with recombinant human follicle-stimulating hormone (follitropin alfa; GONAL-f): long-term treatment in azoospermic men with hypogonadotropic hypogonadism. Fertil Steril. 2009 Sep;92(3):979-990. doi: 10.1016/j.fertnstert.2008.07.1742. Epub 2008 Oct 18. |
| ID | Term |
|---|---|
| D007006 | Hypogonadism |
| D017436 | Kallmann Syndrome |
| D007246 | Infertility |
| ID | Term |
|---|---|
| D006058 | Gonadal Disorders |
| D004700 | Endocrine System Diseases |
| D058490 | Disorder of Sex Development, 46,XY |
| D012734 | Disorders of Sex Development |
| D014564 | Urogenital Abnormalities |
| D052776 | Female Urogenital Diseases |
| D005261 | Female Urogenital Diseases and Pregnancy Complications |
| D000091642 | Urogenital Diseases |
| D052801 | Male Urogenital Diseases |
| D000013 | Congenital Abnormalities |
| D009358 | Congenital, Hereditary, and Neonatal Diseases and Abnormalities |
| D030342 | Genetic Diseases, Inborn |
| D000091662 | Genital Diseases |
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| ID | Term |
|---|---|
| D006063 | Chorionic Gonadotropin |
| D008596 | Menotropins |
| ID | Term |
|---|---|
| D006062 | Gonadotropins |
| D036361 | Peptide Hormones |
| D006728 | Hormones |
| D006730 | Hormones, Hormone Substitutes, and Hormone Antagonists |
| D010926 | Placental Hormones |
| D010455 | Peptides |
| D000602 | Amino Acids, Peptides, and Proteins |
| D011257 | Pregnancy Proteins |
| D011506 | Proteins |
| D006065 | Gonadotropins, Pituitary |
| D010908 | Pituitary Hormones, Anterior |
| D010907 | Pituitary Hormones |
| D001688 | Biological Products |
| D045424 | Complex Mixtures |
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