The effectiveness of zinc supplementation in men with isolated hypogonadotropic hypogonadism

• Main Authors: Yan-Ling Liu, Man-Na Zhang, Guo-Yu Tong, Shou-Yue Sun, Yan-Hua Zhu, Ying Cao, Jie Zhang, Hong Huang, Ben Niu, Hong Li, Qing-Hua Guo, Yan Gao, Da-Long Zhu, Xiao-Ying Li, on behalf of Hypogonadotropic Hypogonadism Intervention Study (HHIS) Group
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2017-01-01
• Series: Asian Journal of Andrology
• Subjects: gonadotropin; isolated hypogonadotropic hypogonadism; masculinization; spermatogenesis; zinc supplementation
• Online Access: http://www.ajandrology.com/article.asp?issn=1008-682X;year=2017;volume=19;issue=3;spage=280;epage=285;aulast=Liu
• ISSN: 1008-682X; 1745-7262

A multicenter, open-label, randomized, controlled superiority trial with 18 months of follow-up was conducted to investigate whether oral zinc supplementation could further promote spermatogenesis in males with isolated hypogonadotropic hypogonadism (IHH) receiving sequential purified urinary follicular-stimulating hormone/human chorionic gonadotropin (uFSH/hCG) replacement. Sixty-seven Chinese male IHH patients were recruited from the Departments of Endocrinology in eight tertiary hospitals and randomly allocated into the sequential uFSH/hCG group (Group A, n = 34) or the sequential uFSH plus zinc supplementation group (Group B, n = 33). In Group A, patients received sequential uFSH (75 U, three times a week every other 3 months) and hCG (2000 U, twice a week) treatments. In Group B, patients received oral zinc supplementation (40 mg day−1 ) in addition to the sequential uFSH/hCG treatment given to patients in Group A. The primary outcome was the proportion of patients with a sperm concentration ≥1.0 × 106 ml−1 during the 18 months. The comparison of efficacy between Groups A and B was analyzed. Nineteen of 34 (55.9%) patients receiving sequential uFSH/hCG and 20 of 33 (60.6%) patients receiving sequential uFSH/hCG plus zinc supplementation achieved sperm concentrations ≥1.0 × 106 ml−1 by intention to treat analyses. No differences between Group A and Group B were observed as far as the efficacy of inducing spermatogenesis (P = 0.69). We concluded that the sequential uFSH/hCG plus zinc supplementation regimen had a similar efficacy to the sequential uFSH/hCG treatment alone. The additional improvement of 40 mg day−1 oral zinc supplementation on spermatogenesis and masculinization in male IHH patients is very subtle.