From the Guidelines
The dose of Human Menopausal Gonadotropin (HMG) for men is not explicitly stated in the provided guideline evidence, but based on the context of treating hypogonadotropic hypogonadism, a common dose range is 75-150 IU administered subcutaneously or intramuscularly 2-3 times per week, often in combination with human chorionic gonadotropin (hCG) at 1,500-2,000 IU 2-3 times weekly 1.
Treatment Overview
The treatment of hypogonadotropic hypogonadism typically involves the use of gonadotropins to stimulate testicular function and spermatogenesis. The guideline evidence suggests that human chorionic gonadotropin (hCG) is often used as the first-line treatment, with doses ranging from 500-2500 IU, 2-3 times weekly 1.
HMG and hCG Combination Therapy
In some cases, HMG may be used in combination with hCG to stimulate both testosterone production and spermatogenesis. The HMG component contains both follicle-stimulating hormone (FSH) and luteinizing hormone (LH) activity, which stimulates testicular function and spermatogenesis, while the hCG component mimics LH to stimulate testosterone production 1.
Monitoring and Adjustments
Regular monitoring of testosterone levels, sperm parameters, and testicular volume is essential to assess treatment efficacy and make necessary dose adjustments. Side effects may include injection site reactions, headache, gynecomastia, and rarely, antibody formation against gonadotropins.
Key Considerations
- The use of exogenous testosterone therapy should be avoided in males pursuing or planning to pursue family building in the near future, as it can inhibit gonadotropin secretion and suppress spermatogenesis 1.
- In patients with non-obstructive azoospermia, clinicians may inform the patient of the limited data supporting pharmacologic manipulation with selective estrogen receptor modulators, aromatase inhibitors, and gonadotropins prior to surgical intervention 1.
From the Research
Dose of Human Menopausal Gonadotropin (HMG) for Men
- The dose of HMG for men is not explicitly stated in the provided studies as a standard or recommended dose.
- However, in the study 2, men with isolated hypogonadotropic hypogonadism were treated with hCG (2000 IU) and hMG (75 IU FSH and 75 IU LH) im 3 times/week.
- In the study 3, men with hypogonadotropic hypogonadism were treated with human gonadotropins (hMG; 150 IU FSH and LH and 1500 IU hCG, im, three times weekly).
- In the study 4, men with hypogonadotrophic hypogonadism were treated with intramuscular injections of gonadotropins (HCG/HMG) three times weekly, but the specific dose of HMG is not mentioned.
- In the study 5, men with idiopathic normogonadotrophic oligozoospermia were treated with hMG plus hCG over a period of 3 months, but the specific dose of HMG is not mentioned.
Studies on HMG Dosage
- The studies 2, 3, 4, 5 provide information on the treatment of men with hypogonadotropic hypogonadism or idiopathic normogonadotrophic oligozoospermia using HMG, but do not provide a clear recommendation for a standard dose of HMG for men.
- The study 6 is not relevant to the question as it discusses the use of HMG in women undergoing intrauterine insemination cycles.