Assessment of quality of life during gonadotrophin treatment for male hypogonadotrophic hypogonadism

Objective The management of male hypogonadotrophic hypogonadism (MHH) with gonadotrophins is effective in promoting genital development and spermatogenesis. We investigated the changes in SF-36 subscales, including physical, social and psychological QOL, during gonadotrophin or testosterone treatment and analysed the factors that are involved in the outcomes of health-related quality of life (HRQOL) in MHH patients. Patients and Design Thirty-seven MHH patients (mean age: 26.1 years old) who underwent gonadotrophin (n = 31) or testosterone treatment (n = 6), excluding infertility cases, were asked to respond to a SF-36 questionnaire before and every 6 months during the 2-year treatment period. The changes in SF-36 domains and the associations between improvements and patient factors were examined. Results The scores in all of the SF-36 domains were lower than in the normal Japanese population. In all eight domains, except for bodily pain and social functioning, the mean scores for physical function (PF), role-physical (RP), general health (GH), vitality (VT), role-emotional (RE) and mental health (MH) significantly increased over the course of treatment in patients with gonadotrophin. These changes were particularly noticeable in the psychological domains; GH, VT, RE and MH exhibited large increases 18 months after treatment. Testosterone treatment increased only PF and RP domains. In patients with sperm in their ejaculate, the improvements in GH, VT, RE and MH were significantly greater than those who did not exhibit sperm. Conclusion Gonadotrophin treatment for MHH was associated with significant improvements in SF-36 domains. Gonadotrophin treatment could prevent negative physical and psychological sequelae in the management of MHH.