期刊
NATURE CLINICAL PRACTICE ENDOCRINOLOGY & METABOLISM
卷 4, 期 7, 页码 415-419出版社
NATURE PUBLISHING GROUP
DOI: 10.1038/ncpendmet0844
关键词
aromatase inhibitor; estradiol; male infertility; obesity-related hypogonadotropic hypogonadism; testosterone
资金
- NIA NIH HHS [K23 AG027238, K23 AG027238-04] Funding Source: Medline
- NICHD NIH HHS [K23 HD045386-05, K23 HD45386, K23 HD045386] Funding Source: Medline
Background A 29-year-old man presented to a clinic with infertility and hypogonadism in the setting of morbid obesity. On presentation, he had notable gynecomastia and a low testicular volume. The patient's weight was 154 kg and his height was 168 cm (BMI 54.5 kg/m(2)). Before referral to the clinic, the patient had been treated with testosterone therapy for 4 months for hypogonadism. This treatment had caused his initially low sperm concentration to fall to undetectable levels. Investigations Measurement of reproductive hormone levels, pituitary MRI, and semen analysis. Diagnosis Infertility secondary to hypogonadotropic hypogonadism and an elevated estrogen:testosterone ratio. Management Treatment with an aromatase inhibitor, anastrozole, led to normalization of the patient's testosterone, luteinizing hormone and follicle-stimulating hormone levels, suppression of serum estradiol levels, and to normalization of spermatogenesis and fertility.
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