{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T21:43:20Z","timestamp":1788903800548,"version":"build-2803163510"},"reference-count":39,"publisher":"The Endocrine Society","issue":"5","license":[{"start":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T00:00:00Z","timestamp":1761782400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,4,22]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Context<\/jats:title>\n                    <jats:p>Gonadotropin treatment to induce spermatogenesis for gonadotropin-deficient men is the only medically treatable cause of male infertility. However, time-dependent analyses of fertility outcomes in large cohorts are lacking. We evaluated the time to, and determinants of, fertility outcomes in men with pathologic gonadotropin-deficiency undergoing gonadotropin treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Consecutive infertile men (n = 99) with congenital or acquired pathologic gonadotropin deficiency were treated with urinary or recombinant human chorionic gonadotropin and FSH according to a standardized protocol between 1983 and 2024. Kaplan-Meier and multivariate Cox regression analyses examined time to prespecified sperm density thresholds and pregnancy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Men aged 35 \u00b1 1 years with female partners 30 \u00b1 1 years underwent 160 treatment cycles. The proportion (%) and median time (months) to achieve sperm thresholds of &amp;gt;0, &amp;gt;2, &amp;gt;5, &amp;gt;10, and &amp;gt;20 million (M) sperm\/mL was 78% (5 months), 56% (12 months), 49% (14 months), 37% (21 months), and 24% (not determined), respectively. The major determinant of successful pregnancy was the presence of adverse fertility factors in the female partner (hazard ratio 0.20, 95% confidence interval 0.10-0.40; P &amp;lt; .001), with time to pregnancy also significantly increased by the presence of adverse female factors (15 vs 43 months; P &amp;lt; .0001). The median sperm concentration associated with partner pregnancy was 2.8 (0.2, 52.6) M\/mL without and 35.4 (15.1, 52.6) M\/mL with adverse female factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Most men with pathologic gonadotropin deficiency treated with hCG\/FSH achieve sperm output and fertility within a year, with the greatest impact on fertility outcomes being detrimental female fertility factors.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1210\/clinem\/dgaf588","type":"journal-article","created":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T13:10:39Z","timestamp":1761743439000},"page":"1450-1458","source":"Crossref","is-referenced-by-count":5,"title":["Efficacy of Gonadotropin Therapy to Induce Spermatogenesis and Fertility in Men with Pathologic Gonadotropin Deficiency"],"prefix":"10.1210","volume":"111","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-5596-9095","authenticated-orcid":false,"given":"Joshua V","family":"Gialouris","sequence":"first","affiliation":[{"name":"ANZAC Research Institute, University of Sydney , Sydney, NSW 2138 ,","place":["Australia"]},{"name":"Andrology, Concord Hospital , Sydney, NSW 2139 ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ann J","family":"Conway","sequence":"additional","affiliation":[{"name":"ANZAC Research Institute, University of Sydney , Sydney, NSW 2138 ,","place":["Australia"]},{"name":"Andrology, Concord Hospital , Sydney, NSW 2139 ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda","family":"Idan","sequence":"additional","affiliation":[{"name":"Andrology, Concord Hospital , Sydney, NSW 2139 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