Low-Dose Human Chorionic Gonadotropin Maintains Intratesticular Testosterone in Normal Men with Testosterone-Induced Gonadotropin Suppression
Abstract
In previous studies of testicular biopsy tissue from healthy men, intratesticular testosterone (ITT) has been shown to be much higher than serum testosterone (T), suggesting that high ITT is needed relative to serum T for normal spermatogenesis in men. However, the quantitative relationship between ITT and spermatogenesis is not known. To begin to address this issue experimentally, we determined the dose-response relationship between human chorionic gonadotropin (hCG) and ITT to ascertain the minimum dose needed to maintain ITT in the normal range. Twenty-nine men with normal reproductive physiology were randomized to receive 200 mg T enanthate weekly in combination with either saline placebo or 125, 250, or 500 IU hCG every other day for 3 wk. ITT was assessed in testicular fluid obtained by percutaneous fine needle aspiration at baseline and at the end of treatment. Baseline serum T (14.1 nmol/liter) was 1.2% of ITT (1174 nmol/liter). LH and FSH were profoundly suppressed to 5% and 3% of baseline, respectively, and ITT was suppressed by 94% (1234 to 72 nmol/liter) in the T enanthate/placebo group. ITT increased linearly with increasing hCG dose (P < 0.001). Posttreatment ITT was 25% less than baseline in the 125 IU hCG group, 7% less than baseline in the 250 IU hCG group, and 26% greater than baseline in the 500 IU hCG group. These results demonstrate that relatively low dose hCG maintains ITT within the normal range in healthy men with gonadotropin suppression. Extensions of this study will allow determination of the ITT concentration threshold required to maintain spermatogenesis in man.
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hCG has been used with concurrent exogenous testosterone to maintain intratesticular testosterone levels and preserve spermatogenesis.
“hCG has also been used with concurrent exogenous testosterone to maintain intratesticular testosterone levels and preserve spermatogenesis (73).”
From Non-testosterone management of male hypogonadism: an examination of the existing literature (2020) · cites this paper as [73]
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- Authors
- Coviello, A. D., Matsumoto, A. M., Bremner, W. J., Herbst, K. L., Amory, J. K., Anawalt, B. D., Sutton, P. R., Wright, W. W., Brown, T. R., Yan, X., Zirkin, B. R., & Jarow, J. P.
- Affiliations
- University of Washington (US)
- VA Puget Sound Health Care System (US)
- Charles R. Drew University of Medicine and Science (US)
- Johns Hopkins University (US)
- Corresponding author
- Coviello, Andrea D.
- ORCID
- Venue
- The Journal of Clinical Endocrinology & Metabolism
- Publisher
- The Endocrine Society
- Published
- 2005-05
- Volume
- 90
- Issue
- 5
- Pages
- 2595-2602
- ISSN
- 0021-972X (ISSN-L)
- 1945-7197
- OpenAlex
- W2105435245
- Cited by
- 154
- References
- 40
- Citations by year
- 2026: 12 · 2025: 12 · 2024: 7 · 2023: 8 · 2022: 5 · 2021: 12 · 2020: 7 · 2019: 7 · 2018: 8 · 2017: 4 · 2016: 12 · 2015: 10 · 2014: 7 · 2013: 9 · 2012: 9
- FWCI
- 4.22
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
- PubMed (publishedVersion)
- ResearchWorks at the University of Washington (University of Washington) (submittedVersion)
- Funders
- National Institutes of Health (5u54hd012629-31, 5u54hd036209-05, 5r01hd044258-05)
- National Center for Research Resources (M01-RR 00037, M01RR000037)
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (HD 44258, T32 HD07453, U54HD042454, U54HD42454, U54-HD-12629, T32HD007453, U54-HD-36209)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Sperm and Testicular Function
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal and reproductive studies
- Health Sciences › Medicine › Reproductive Medicine › Hypothalamic control of reproductive hormones
- Keywords
- human chorionic gonadotropin, intratesticular testosterone, testosterone enanthate, gonadotropin suppression, dose-response relationship, testicular fluid, spermatogenesis, luteinizing hormone, follicle-stimulating hormone, testicular biopsy, healthy men
- MeSH terms
- Adolescent, Adult, Follicle Stimulating Hormone, Chorionic Gonadotropin, Humans, Luteinizing Hormone, Male, Middle Aged, Regression Analysis, Testis, Testosterone
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