Disorders of the hypothalamus and pituitary gland
Occasionally, male infertility can be due to a decrease or absence in the production of two hormones essential for sperm production: follicle stimulating hormone (FSH) and luteinizing hormone (LH). For example, patients born with Kallmann syndrome have a deficiency in the pulsatile secretion of gonadotropin-releasing hormone (GnRH) which in turn leads to a lack of stimulation to the pituitary gland to produce FSH or LH. This leads to lack of FSH and LH. Without LH the testicle does not get adequate stimulation to produce testosterone. Without the critical intra-testicular production of testosterone for stimulation of sperm production, patients typically cannot produce sperm. Without FSH the testicle is not optimally stimulated to produce sperm even if there were to be adequate intra-testicular testosterone. Occasionally, patients who have used testosterone supplements for a long time can also have a “quiet” or “dormant” pituitary gland that does not produce normal amounts of FSH and LH leading to infertility.
Dr. Clavijo is fellowship trained to treat patients with these types of conditions (hypogonadotropic hypogonadism) who are attempting to conceive or are thinking about conceiving in the near/distant future. Patients are typically treated with long term courses of hormones such as hCG (human chorionic gonadotropin) and FSH. Some patients are candidates for treatments such as clomid as well. Our clinic can help you manage medication doses, laboratory tests, and coordinate semen analyses to follow treatment results.