A 22-year-old boy with hyposmia presents lack of development of secondary sexual characteristics and infertility. Bilateral testicular volume of 4 mL. Analytically, EST-I 1.2 U/L (vn 5-15); LH 0.6 U/L (vn 3-15); testosterone 100 ng/dL (vn 300-1200), prolactin normal. State your proposed treatment to achieve fertility:
This is a Kallman syndrome (hypogonadotropic hypogonadism + olfactory disturbance). Triptorelin is a GnRH agonist, which by continuous action reduces FSH and LH, and is used in sex hormone-dependent cancers, as well as precocious puberty. Bromocriptine is a dopaminergic agonist used in hyperPRL (he has normal PRL), pituitary tumors... We stay between 1 and 3. To induce testicular maturation, pulsatile GnRH with pump, hCG or FSH+hCG can be used. LH is not used as a treatment, it would be stimulated by intermittent GnRH.
GnRH infusion pump.
Monthly intramuscular administration of triptorelin.
Intramuscular administration of FSH and LH once a week.
Treatment with bromocriptine.
To induce testicular maturation, pulsatile GnRH with pump, hCG or FSH+hCG can be used.
Triptorelin is a GnRH agonist, which by continuous action reduces FSH and LH, and is used in sex hormone-dependent cancers, as well as precocious puberty.
LH is not used as a treatment, it would be stimulated by intermittent GnRH.
Bromocriptine is a dopaminergic agonist used in hyperPRL (he has normal PRL), pituitary tumors...