Treatment of hypogonadotropic male hypogonadism: Case-based scenarios

Table 1 Treatment options for hypogonadism in men desiring to preserve their fertility

Name of medication	Dosing and administration	Side effects	Anticipated results
Clomiphene	Oral: 25 mg every other day with max of 50 mg daily	Gynecomastia, weight gain, hypertension, cataracts, and acne	Recovery of spermatogenetic function, increases in testosterone levels
hCG	Intramuscular injection; 125-500 IU every other day	Headache, restlessness, tiredness, swelling of the ankles/feet, mental/mood changes, pain/swelling of the breast	Recovery of spermatogenetic function, increases in testosterone levels
hMG	Intramuscular injection; 75 IU three times a week	Gynecomastia, dizziness, fainting, headache, loss of appetite, irregular heartbeat	Recovery of spermatogenetic function
Anastrozole	Oral; either 0.5 or 1 mg	Blood pressure increase, anorexia, malaise, rash, peripheral edema, aches glossitis, paresthesias vomiting/nausea	Improvements in T/E2 ratio, increases in sperm concentration

IU: International units; hMG: Human menopausal gonadotropin; T/E2 ratio: Testosterone/estradiol ratio; hCG: Human chorionic gonadotropin.