madman
Super Moderator
* Human chorionic gonadotropin (hCG) therapy can be co-administered with TTh to maintain spermatogenesis, testicular size, or libido, but no study has assessed associated 17-OHP levels in these men on concurrent TTh and hCG therapy. levels in men on TTh.
* In our practice, hCG 1500 IU subcutaneous injection is prescribed once weekly to maintain spermatogenesis while on TTh, 1500 IU twice weekly to restore testicular size or improve libido while on TTh, or 3000 IU three times weekly plus FSH and TTh when attempting to reboot spermatogenesis after TTh therapy allowing men to remain on TTh.
* There is a dose-dependent relationship between serum 17-OHP and increasing hCG doses when co-administered with TTh. Further work is needed to determine whether there are thresholds for 17-OHP levels associated with spermatogenesis or impaired libido.
DOSE-DEPENDENT INCREASE OF 17-HYDROXYPROGESTERONE LEVELS BY VARYING DOSES OF HUMAN CHORIONIC GONADOTROPIN TREATMENT IN MEN RECEIVING TESTOSTERONE THERAPY
Taylor P. Kohn, Mahdi A. Bazzi, Niki N. Parikh, Amelia G. Oppenheimer,Houston, TX; Corey A. Able*, Galveston, TX; Blair T. Stocks,Larry I. Lipshultz, Houston, TX
INTRODUCTION AND OBJECTIVE
17-Hydroxyprogesterone (17-OHP) is a reliable surrogate of intra-testicular testosterone levels. Exogenous testosterone therapy (TTh) causes negative feedback in the hypothalamic-pituitary-gonadal axis, reducing secretion of gonadotropins, and resulting in impaired intra-testicular testosterone as exogenous TTh does not cross the blood-testis barrier. Human chorionic gonadotropin (hCG) therapy can be co-administered with TTh to maintain spermatogenesis, testicular size, or libido, but no study has assessed associated 17-OHP levels in these men on concurrent TTh and hCG therapy. The objective of this study is to determine whether there is a dose-dependent association between hCG dose and 17-OHP levels in men on TTh.
METHODS
We identified men who were on concurrent TTh and varying hCG therapies. In our practice, hCG 1500 IU subcutaneous injection is prescribed once weekly to maintain spermatogenesis while on TTh, 1500 IU twice weekly to restore testicular size or improve libido while on TTh, or 3000 IU three times weekly plus FSH and TTh when attempting to reboot spermatogenesis after TTh therapy allowing men to remain on TTh. 17-OHP levels were obtained through a commercial laboratory; detection limit for 17-OHP was 10 ng/dL. Men were excluded if an hCG injection was greater than 1 week prior to lab testing. We included for comparison the following: men on TTh monotherapy without concurrent hCG, men with hypogonadal symptoms not on TTh with a recent history of fathering a child, and infertile men on enclomiphene.
CONCLUSIONS
There is a dose-dependent relationship between serum 17-OHP and increasing hCG doses when co-administered with TTh. Further work is needed to determine whether there are thresholds for 17-OHP levels associated with spermatogenesis or impaired libido. 17-OHP may become an important biomarker to non-invasively trend for men on TTh as a proxy for intra-testicular testosterone and its sequelae.
* In our practice, hCG 1500 IU subcutaneous injection is prescribed once weekly to maintain spermatogenesis while on TTh, 1500 IU twice weekly to restore testicular size or improve libido while on TTh, or 3000 IU three times weekly plus FSH and TTh when attempting to reboot spermatogenesis after TTh therapy allowing men to remain on TTh.
* There is a dose-dependent relationship between serum 17-OHP and increasing hCG doses when co-administered with TTh. Further work is needed to determine whether there are thresholds for 17-OHP levels associated with spermatogenesis or impaired libido.
DOSE-DEPENDENT INCREASE OF 17-HYDROXYPROGESTERONE LEVELS BY VARYING DOSES OF HUMAN CHORIONIC GONADOTROPIN TREATMENT IN MEN RECEIVING TESTOSTERONE THERAPY
Taylor P. Kohn, Mahdi A. Bazzi, Niki N. Parikh, Amelia G. Oppenheimer,Houston, TX; Corey A. Able*, Galveston, TX; Blair T. Stocks,Larry I. Lipshultz, Houston, TX
INTRODUCTION AND OBJECTIVE
17-Hydroxyprogesterone (17-OHP) is a reliable surrogate of intra-testicular testosterone levels. Exogenous testosterone therapy (TTh) causes negative feedback in the hypothalamic-pituitary-gonadal axis, reducing secretion of gonadotropins, and resulting in impaired intra-testicular testosterone as exogenous TTh does not cross the blood-testis barrier. Human chorionic gonadotropin (hCG) therapy can be co-administered with TTh to maintain spermatogenesis, testicular size, or libido, but no study has assessed associated 17-OHP levels in these men on concurrent TTh and hCG therapy. The objective of this study is to determine whether there is a dose-dependent association between hCG dose and 17-OHP levels in men on TTh.
METHODS
We identified men who were on concurrent TTh and varying hCG therapies. In our practice, hCG 1500 IU subcutaneous injection is prescribed once weekly to maintain spermatogenesis while on TTh, 1500 IU twice weekly to restore testicular size or improve libido while on TTh, or 3000 IU three times weekly plus FSH and TTh when attempting to reboot spermatogenesis after TTh therapy allowing men to remain on TTh. 17-OHP levels were obtained through a commercial laboratory; detection limit for 17-OHP was 10 ng/dL. Men were excluded if an hCG injection was greater than 1 week prior to lab testing. We included for comparison the following: men on TTh monotherapy without concurrent hCG, men with hypogonadal symptoms not on TTh with a recent history of fathering a child, and infertile men on enclomiphene.
CONCLUSIONS
There is a dose-dependent relationship between serum 17-OHP and increasing hCG doses when co-administered with TTh. Further work is needed to determine whether there are thresholds for 17-OHP levels associated with spermatogenesis or impaired libido. 17-OHP may become an important biomarker to non-invasively trend for men on TTh as a proxy for intra-testicular testosterone and its sequelae.
