Treatment algorithm

Please note that formulations/routes and doses may differ between drug names and brands, drug formularies, or locations. Treatment recommendations are specific to patient groups: see disclaimer

ONGOING

nongonadal illness

1st line – treatment of the underlying cause

Back
ONGOING
|
nongonadal illness
1st line – 

treatment of the underlying cause

Men with physiologically suppressed gonadotropins and testosterone concentrations due to a nongonadal illness should receive treatment of the underlying cause. For instance, obesity is a common cause of nongonadal illness, which may be reversed by lifestyle intervention.

Consider – testosterone therapy

Back
ONGOING
|
nongonadal illness
Consider – 

testosterone therapy

Treatment recommended for SOME patients in selected patient group

When nongonadal illness cannot be reversed with treatment of the underlying cause, testosterone therapy may be considered.

The therapeutic aim is to reverse hypogonadal symptoms and signs, and achieve physiologic testosterone levels in the mid-normal range (subject to maintaining normal hemoglobin and hematocrit).

The choice of testosterone formulation and route of administration should be informed by shared decision-making and guided by efficacy, patient preference, ease of use, and safety.[54]

The adequacy of testosterone therapy is assessed by clinical symptoms, serum testosterone levels, and relevant biomarkers such as hematocrit and bone density.[28][54]

Patients require regular follow-up to ensure compliance, assess effectiveness, adjust dosing, and monitor for adverse effects. Patients should be reviewed at regular intervals (every 3-4 months) during the first year of treatment, and annually thereafter.[29][37]​​​​ Dose titration or adjustment of injection interval may be required to attain adequate circulating testosterone levels and to maintain normal hematocrit. 

Topical and transdermal formulations include gels, solution, and (in some countries) patches; these require once-daily application. Testosterone levels can be checked to see if they have reached therapeutic levels after 1 week of using transdermal products; hematocrit will take approximately 2 months to reach a steady state. Physiologic serum levels can be achieved with dose adjustment. Testosterone level should be measured 6-12 hours after gel application as this gives the mid-point value.

Transfer of testosterone from patient to partner or child through skin-to-skin contact has been reported in patients using gel or cream preparations, but is extremely rare. This can be avoided by washing hands after application, and covering treated skin areas with clothing.[54]

A long-acting intramuscular formulation (testosterone undecanoate) can be given every 10-16 weeks to maintain testosterone levels within the normal physiologic range. Testosterone levels should be measured either immediately prior to an injection (i.e., trough level) to ensure concentration is near the low-normal range, or at the mid-point between injections, aiming for a mid-range testosterone concentration.

Short-acting forms of intramuscular testosterone include esters such as testosterone cypionate and testosterone enanthate. Short-acting injectable formulations are normally administered every 2-4 weeks (depending on the formulation).

Serum testosterone levels achieved with short-acting intramuscular injections of testosterone are highly variable due to medication decay. Immediately after injection, supraphysiologic levels may occur. Levels then decline, reaching near hypogonadal levels at 2 weeks postinjection. For this reason, trough levels should be measured.

Erythrocytosis and gynecomastia occur more commonly with intramuscular injections than with transdermal preparations.

All intramuscular preparations of testosterone should be warmed to body temperature and administered slowly to reduce discomfort. Long-acting intramuscular testosterone undecanoate should be administered over 60-90 seconds to reduce injection pain and the risk of pulmonary oil microembolism (POME).

Oral testosterone undecanoate is an equivalent alternative to testosterone gel with minimal adverse effects (transient liver enzyme elevation, but without the liver toxicity associated with methyltestosterone-based oral formulations), ease of use, and high patient compliance.[56][57][58]​​​​

Long-acting testosterone pellets for subcutaneous implantation may be an option for patients in some countries. Implants last up to 6 months, depending on the number of pellets used. Patients require monitoring to determine how many pellets should be implanted to maintain testosterone levels.[54][59]​​​ Implantation is invasive and extrusions can occur.[54]

Other formulations or brands of testosterone may be available; consult your local drug formulary for more information.

Primary options

testosterone transdermal: (1% gel) apply 50-100 mg once daily; (1.62% gel) apply 20.25 to 81 mg once daily; (2% gel) apply 10-70 mg once daily; (2% solution) apply 30-120 mg once daily

More

OR

testosterone nasal: (5.5 mg/actuation) 1 actuation in each nostril (11 mg total) three times daily

More

OR

testosterone undecanoate: consult specialist for guidance on dose

More

OR

testosterone cypionate: consult specialist for guidance on dose

More

OR

testosterone enanthate: consult specialist for guidance on dose

More

OR

testosterone: (pellet) 150-450 mg subcutaneously every 3-6 months

More

not desiring fertility currently: primary hypogonadism

1st line – testosterone therapy

Back
ONGOING
|
not desiring fertility currently: primary hypogonadism
1st line – 

testosterone therapy

The therapeutic aim is to reverse hypogonadal symptoms and signs, and achieve physiologic testosterone levels in the mid-normal range (subject to maintaining normal hemoglobin and hematocrit).

The choice of testosterone formulation and route of administration should be informed by shared decision-making and guided by efficacy, patient preference, ease of use, and safety.[54]

The adequacy of testosterone therapy is assessed by clinical symptoms, serum testosterone levels, and relevant biomarkers such as hematocrit and bone density.[28][54]

Patients require regular follow-up to ensure compliance, assess effectiveness, adjust dosing, and monitor for adverse effects. Patients should be reviewed at regular intervals (every 3-4 months) during the first year of treatment, and annually thereafter.[29][37]​​​ Dose titration or adjustment of injection interval may be required to attain adequate circulating testosterone levels and to maintain normal hematocrit.

Topical and transdermal formulations include gels, solution, and (in some countries) patches; these require once-daily application. Testosterone levels can be checked to see if they have reached therapeutic levels after 1 week of using transdermal products; hematocrit will take approximately 2 months to reach a steady state. Physiologic serum levels can be achieved with dose adjustment. Testosterone level should be measured 6-12 hours after gel application as this gives the mid-point value.

Transfer of testosterone from patient to partner or child through skin-to-skin contact has been reported in patients using gel or cream preparations, but is extremely rare. This can be avoided by washing hands after application, and covering treated skin areas with clothing.[54]

A long-acting intramuscular formulation (testosterone undecanoate) can be given every 10-16 weeks to maintain testosterone levels within the normal physiologic range. Testosterone levels should be measured either immediately prior to an injection (i.e., trough level) to ensure concentration is near the low-normal range, or at the mid-point between injections, aiming for a mid-range testosterone concentration.

Short-acting forms of intramuscular testosterone include esters such as testosterone cypionate and testosterone enanthate. Short-acting injectable formulations are normally administered every 2-4 weeks (depending on the formulation). Serum testosterone levels achieved with short-acting intramuscular injections of testosterone are highly variable due to medication decay. Immediately after injection, supraphysiologic levels may occur. Levels then decline, reaching near hypogonadal levels at 2 weeks postinjection. For this reason, trough levels should be measured.

Erythrocytosis and gynecomastia occur more commonly with intramuscular injections than with transdermal preparations.

All intramuscular preparations of testosterone should be warmed to body temperature and administered slowly to reduce discomfort. Long-acting intramuscular testosterone undecanoate should be administered over 60-90 seconds to reduce injection pain and the risk of pulmonary oil microembolism (POME).

Oral testosterone undecanoate is an equivalent alternative to testosterone gel with minimal adverse effects (transient liver enzyme elevation, but without the liver toxicity associated with methyltestosterone-based oral formulations), ease of use, and high patient compliance.[56][57][58]

Long-acting testosterone pellets for subcutaneous implantation may be an option for patients in some countries. Implants last up to 6 months, depending on the number of pellets used. Patients require monitoring to determine how many pellets should be implanted to maintain testosterone levels.[54][59] Implantation is invasive and extrusions can occur.[54]

Other formulations or brands of testosterone may be available; consult your local drug formulary for more information.

Primary options

testosterone transdermal: (1% gel) apply 50-100 mg once daily; (1.62% gel) apply 20.25 to 81 mg once daily; (2% gel) apply 10-70 mg once daily; (2% solution) apply 30-120 mg once daily

More

OR

testosterone nasal: (5.5 mg/actuation) 1 actuation in each nostril (11 mg total) three times daily

More

OR

testosterone undecanoate: consult specialist for guidance on dose

More

OR

testosterone cypionate: consult specialist for guidance on dose

More

OR

testosterone enanthate: consult specialist for guidance on dose

More

OR

testosterone: (pellet) 150-450 mg subcutaneously every 3-6 months

More

not desiring fertility currently: secondary hypogonadism

1st line – dopamine agonist

Back
ONGOING
|
not desiring fertility currently: secondary hypogonadism
|
due to prolactinoma
1st line – 

dopamine agonist

A dopamine agonist, such as cabergoline or bromocriptine, is first-line treatment.[71]​​ Patients should be referred to an endocrinologist for management, which will include magnetic resonance imaging (MRI) of the pituitary gland, and visual field assessment (due to the association with bitemporal hemianopia in prolactin-secreting macroadenomas).

Inform patients of the risk of rare but devastating psychiatric adverse effects with dopamine agonists, such as impulse control disorders.[72]

Cabergoline is more potent than bromocriptine, has a better adverse effect profile, and only needs to be taken twice weekly. It is a selective dopamine-2 agonist; bromocriptine is a combined dopamine-1/dopamine-2 agonist.

Testosterone therapy can be initiated to improve symptoms of hypogonadism in the small percentage of patients who do not respond to a dopamine agonist, or as bridging therapy to alleviate patient symptoms until the dopamine agonist takes effect.

Primary options

cabergoline: 0.25 to 1 mg orally twice weekly

Secondary options

bromocriptine: 2.5 to 15 mg orally once daily

Consider – testosterone therapy

Back
ONGOING
|
not desiring fertility currently: secondary hypogonadism
|
due to prolactinoma
Consider – 

testosterone therapy

Treatment recommended for SOME patients in selected patient group

Testosterone therapy can be initiated to improve symptoms of hypogonadism in the small percentage of patients who do not respond to a dopamine agonist, or as a bridging treatment to relieve symptoms until the dopamine agonist takes effect.

The therapeutic aim is to reverse hypogonadal symptoms and signs, and achieve physiologic testosterone levels in the mid-normal range (subject to maintaining normal hemoglobin and hematocrit).

The choice of testosterone formulation and route of administration should be informed by shared decision-making and guided by efficacy, patient preference, ease of use, and safety.[54]

The adequacy of testosterone therapy is assessed by clinical symptoms, serum testosterone levels, and relevant biomarkers such as hematocrit and bone density.[28][54]

Patients require regular follow-up to ensure compliance, assess effectiveness, adjust dosing, and monitor for adverse effects. Patients should be reviewed at regular intervals (every 3-4 months) during the first year of treatment, and annually thereafter.[29][37]​​​ Dose titration may be required to attain adequate circulating testosterone levels and to maintain normal hematocrit.

Topical and transdermal formulations include gels, solution, and (in some countries) patches; these require once-daily application. Testosterone levels can be checked to see if they have reached therapeutic levels after 1 week of using transdermal products; hematocrit will take approximately 2 months to reach a steady state. Physiologic serum levels can be achieved with dose adjustment. Testosterone level should be measured 6-12 hours after gel application as this gives the mid-point value.

Transfer of testosterone from patient to partner or child through skin-to-skin contact has been reported in patients using gel or cream preparations, but is extremely rare. This can be avoided by washing hands after application, and covering treated skin areas with clothing.[54]

A long-acting intramuscular formulation (testosterone undecanoate) can be given every 10-16 weeks to maintain testosterone levels within the normal physiologic range. Testosterone levels should be measured either immediately prior to an injection (i.e., trough level) to ensure concentration is near the low-normal range, or at the mid-point between injections, aiming for a mid-range testosterone concentration.

Short-acting forms of intramuscular testosterone include esters such as testosterone cypionate and testosterone enanthate. Short-acting injectable formulations are normally administered every 2-4 weeks (depending on the formulation). Serum testosterone levels achieved with short-acting intramuscular injections of testosterone are highly variable due to medication decay. Immediately after injection, supraphysiologic levels may occur. Levels then decline, reaching near hypogonadal levels at 2 weeks postinjection. For this reason, trough levels should be measured.

Erythrocytosis and gynecomastia occur more commonly with intramuscular injections than with transdermal preparations.

All intramuscular preparations of testosterone should be warmed to body temperature and administered slowly to reduce discomfort. Long-acting intramuscular testosterone undecanoate should be administered over 60-90 seconds to reduce injection pain and the risk of pulmonary oil microembolism (POME).

Oral testosterone undecanoate is an equivalent alternative to testosterone gel with minimal adverse effects (transient liver enzyme elevation, but without the liver toxicity associated with methyltestosterone-based oral formulations), ease of use, and high patient compliance.[56][57][58]

Long-acting testosterone pellets for subcutaneous implantation may be an option for patients in some countries. Implants last up to 6 months, depending on the number of pellets used. Patients require monitoring to determine how many pellets should be implanted to maintain testosterone levels.[54][59]​​​​ Implantation is invasive and extrusions can occur.[54]

Other formulations or brands of testosterone may be available; consult your local drug formulary for more information.

Primary options

testosterone transdermal: (1% gel) apply 50-100 mg once daily; (1.62% gel) apply 20.25 to 81 mg once daily; (2% gel) apply 10-70 mg once daily; (2% solution) apply 30-120 mg once daily

More

OR

testosterone nasal: (5.5 mg/actuation) 1 actuation in each nostril (11 mg total) three times daily

More

OR

testosterone undecanoate: consult specialist for guidance on dose

More

OR

testosterone cypionate: consult specialist for guidance on dose

More

OR

testosterone enanthate: consult specialist for guidance on dose

More

OR

testosterone: (pellet) 150-450 mg subcutaneously every 3-6 months

More

Consider – surgery

Back
ONGOING
|
not desiring fertility currently: secondary hypogonadism
|
due to prolactinoma
Consider – 

surgery

Treatment recommended for SOME patients in selected patient group

Surgery is considered when the patient is resistant to, or intolerant of, dopamine agonists, or has recurrent tumor after dopamine agonist withdrawal. Preferred surgical candidates include those patients with enclosed microadenoma.[73] Surgery is less preferred for patients with an invasive prolactinoma because postoperative remission rates are less favorable.[74] Surgery itself may cause damage to normal pituitary tissue; the decision to perform surgery should take into account surgeon experience and possibility of complications. Surgery, as with dopamine agonist therapy, may lead to some reversal of the hypogonadism.

1st line – testosterone therapy

Back
ONGOING
|
not desiring fertility currently: secondary hypogonadism
|
isolated hypogonadotropic hypogonadism
1st line – 

testosterone therapy

The therapeutic aim is to reverse hypogonadal symptoms and signs, and achieve physiologic testosterone levels in the mid-normal range (subject to maintaining normal hemoglobin and hematocrit).

The choice of testosterone formulation and route of administration should be informed by shared decision-making and guided by efficacy, patient preference, ease of use, and safety.[54]

The adequacy of testosterone therapy is assessed by clinical symptoms, serum testosterone levels, and relevant biomarkers such as hematocrit and bone density.[28][54]

Patients require regular follow-up to ensure compliance, assess effectiveness, adjust dosing, and monitor for adverse effects. Patients should be reviewed at regular intervals (every 3-4 months) during the first year of treatment, and annually thereafter.[29][37]​​​ Dose titration or adjustment of injection interval may be required to attain adequate circulating testosterone levels and to maintain normal hematocrit.

Topical and transdermal formulations include gels, solution, and (in some countries) patches; these require once-daily application. Testosterone levels can be checked to see if they have reached therapeutic levels after 1 week of using transdermal products; hematocrit will take approximately 2 months to reach a steady state. Physiologic serum levels can be achieved with dose adjustment. Testosterone level should be measured 6-12 hours after gel application as this gives the mid-point value.

Transfer of testosterone from patient to partner or child through skin-to-skin contact has been reported in patients using gel or cream preparations, but is extremely rare. This can be avoided by washing hands after application, and covering treated skin areas with clothing.[54]

A long-acting intramuscular formulation (testosterone undecanoate) can be given every 10-16 weeks to maintain testosterone levels within the normal physiologic range. Testosterone levels should be measured either immediately prior to an injection (i.e., trough level) to ensure concentration is near the low-normal range, or at the mid-point between injections, aiming for a mid-range testosterone concentration.

Short-acting forms of intramuscular testosterone include esters such as testosterone cypionate and testosterone enanthate. Short-acting injectable formulations are normally administered every 2-4 weeks (depending on the formulation). Serum testosterone levels achieved with short-acting intramuscular injections of testosterone are highly variable due to medication decay. Immediately after injection, supraphysiologic levels may occur. Levels then decline, reaching near hypogonadal levels at 2 weeks postinjection. For this reason, trough levels should be measured.

Erythrocytosis and gynecomastia occur more commonly with intramuscular injections than with transdermal preparations.

All intramuscular preparations of testosterone should be warmed to body temperature and administered slowly to reduce discomfort. Long-acting intramuscular testosterone undecanoate should be administered over 60-90 seconds to reduce injection pain and the risk of pulmonary oil microembolism (POME).

Oral testosterone undecanoate is an equivalent alternative to testosterone gel with minimal adverse effects (transient liver enzyme elevation, but without the liver toxicity associated with methyltestosterone-based oral formulations), ease of use, and high patient compliance.[56][57][58]

Long-acting testosterone pellets for subcutaneous implantation may be an option for patients in some countries. Implants last up to 6 months, depending on the number of pellets used. Patients require monitoring to determine how many pellets should be implanted to maintain testosterone levels.[54][59]​​​​ Implantation is invasive and extrusions can occur.[54]

Other formulations or brands of testosterone may be available; consult your local drug formulary for more information.

Primary options

testosterone transdermal: (1% gel) apply 50-100 mg once daily; (1.62% gel) apply 20.25 to 81 mg once daily; (2% gel) apply 10-70 mg once daily; (2% solution) apply 30-120 mg once daily

More

OR

testosterone nasal: (5.5 mg/actuation) 1 actuation in each nostril (11 mg total) three times daily

More

OR

testosterone undecanoate: consult specialist for guidance on dose

More

OR

testosterone cypionate: consult specialist for guidance on dose

More

OR

testosterone enanthate: consult specialist for guidance on dose

More

OR

testosterone: (pellet) 150-450 mg subcutaneously every 3-6 months

More

1st line – testosterone therapy

Back
ONGOING
|
not desiring fertility currently: secondary hypogonadism
|
combined pituitary hormone deficiency
1st line – 

testosterone therapy

The therapeutic aim is to reverse hypogonadal symptoms and signs, and achieve physiologic testosterone levels in the mid-normal range (subject to maintaining normal hemoglobin and hematocrit).

The choice of testosterone formulation and route of administration should be informed by shared decision-making and guided by efficacy, patient preference, ease of use, and safety.[54]

The adequacy of testosterone therapy is assessed by clinical symptoms, serum testosterone levels, and relevant biomarkers such as hematocrit and bone density.[28][54]

Patients require regular follow-up to ensure compliance, assess effectiveness, adjust dosing, and monitor for adverse effects. Patients should be reviewed at regular intervals (every 3-4 months) during the first year of treatment, and annually thereafter.[29][37]​​​ Dose titration or adjustment of injection interval may be required to attain adequate circulating testosterone levels and to maintain normal hematocrit.

Topical and transdermal formulations include gels, solution, and (in some countries) patches; these require once-daily application. Testosterone levels can be checked to see if they have reached therapeutic levels after 1 week of using transdermal products; hematocrit will take approximately 2 months to reach a steady state. Physiologic serum levels can be achieved with dose adjustment. Testosterone level should be measured 6-12 hours after gel application as this gives the mid-point value.

Transfer of testosterone from patient to partner or child through skin-to-skin contact has been reported in patients using gel or cream preparations, but is extremely rare. This can be avoided by washing hands after application, and covering treated skin areas with clothing.[54]

A long-acting intramuscular formulation (testosterone undecanoate) can be given every 10-16 weeks to maintain testosterone levels within the normal physiologic range. Testosterone levels should be measured either immediately prior to an injection (i.e., trough level) to ensure concentration is near the low-normal range, or at the mid-point between injections, aiming for a mid-range testosterone concentration.

Short-acting forms of intramuscular testosterone include esters such as testosterone cypionate and testosterone enanthate. Short-acting injectable formulations are normally administered every 2-4 weeks (depending on the formulation). Serum testosterone levels achieved with short-acting intramuscular injections of testosterone are highly variable due to medication decay. Immediately after injection, supraphysiologic levels may occur. Levels then decline, reaching near hypogonadal levels at 2 weeks postinjection. For this reason, trough levels should be measured.

Erythrocytosis and gynecomastia occur more commonly with intramuscular injections than with transdermal preparations.

All intramuscular preparations of testosterone should be warmed to body temperature and administered slowly to reduce discomfort. Long-acting intramuscular testosterone undecanoate should be administered over 60-90 seconds to reduce injection pain and the risk of pulmonary oil microembolism (POME).

Oral testosterone undecanoate is an equivalent alternative to testosterone gel with minimal adverse effects (transient liver enzyme elevation, but without the liver toxicity associated with methyltestosterone-based oral formulations), ease of use, and high patient compliance.[56][57][58]

Long-acting testosterone pellets for subcutaneous implantation may be an option for patients in some countries. Implants last up to 6 months, depending on the number of pellets used. Patients require monitoring to determine how many pellets should be implanted to maintain testosterone levels.[54][59]​​​​ Implantation is invasive and extrusions can occur.[54]

Other formulations or brands of testosterone may be available; consult your local drug formulary for more information.

Primary options

testosterone transdermal: (1% gel) apply 50-100 mg once daily; (1.62% gel) apply 20.25 to 81 mg once daily; (2% gel) apply 10-70 mg once daily; (2% solution) apply 30-120 mg once daily

More

OR

testosterone nasal: (5.5 mg/actuation) 1 actuation in each nostril (11 mg total) three times daily

More

OR

testosterone undecanoate: consult specialist for guidance on dose

More

OR

testosterone cypionate: consult specialist for guidance on dose

More

OR

testosterone enanthate: consult specialist for guidance on dose

More

OR

testosterone: (pellet) 150-450 mg subcutaneously every 3-6 months

More

Plus – treatment of associated pituitary hormone deficiencies

Back
ONGOING
|
not desiring fertility currently: secondary hypogonadism
|
combined pituitary hormone deficiency
Plus – 

treatment of associated pituitary hormone deficiencies

Treatment recommended for ALL patients in selected patient group

Confirmation of the diagnosis of secondary (also known as central or hypogonadotropic) hypogonadism requires a full pituitary evaluation to rule out other anterior and/or posterior pituitary hormone dysfunction, and treatment of any deficiencies.

desiring fertility currently: primary hypogonadism

1st line – assisted reproductive technology (ART)

Back
ONGOING
|
desiring fertility currently: primary hypogonadism
1st line – 

assisted reproductive technology (ART)

Techniques such as in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) involve the administration of hormonal treatment to the female partner to stimulate ovarian follicle growth. Eggs are collected, fertilized, then reimplanted (embryo transfer) into the uterus.

Surgical sperm retrieval, particularly microdissection testicular sperm extraction (micro-TESE), is an option to extract viable sperm for IVF/ICSI in men with hypogonadism and azoospermia. See Male factor infertility.

desiring fertility currently: secondary hypogonadism

1st line – gonadotropin therapy

Back
ONGOING
|
desiring fertility currently: secondary hypogonadism
1st line – 

gonadotropin therapy

Prior testosterone therapy does not significantly impair future semen quality in men with congenital hypogonadotropic hypogonadism.[75]

Patients should be reassured that testosterone therapy is suitable and safe for men to take until they are approximately 1-2 years from wishing to conceive with their partner. Once men want to conceive, they may be switched from testosterone to human chorionic gonadotropin (hCG) alone or in combination with FSH (e.g., urofollitropin, follitropin alfa, follitropin beta) to stimulate spermatogenesis in the testes and secretion of endogenous testosterone.[76] Treatment may need to be continued for up to 2 years. Pulsatile gonadotropin-releasing hormone therapy is seldom available outside the research setting

Patients with adult-onset secondary hypogonadism may achieve restoration of spermatogenesis and fertility with human chorionic hCG monotherapy. If hCG monotherapy is unsuccessful, FSH may be added. Those with combined pituitary hormone deficiency or congenital hypogonadotropic hypogonadism, will need hCG combined with FSH.

Primary options

chorionic gonadotropin: consult specialist for guidance on dose

OR

chorionic gonadotropin: consult specialist for guidance on dose

-- AND --

urofollitropin: consult specialist for guidance on dose

or

follitropin alfa: consult specialist for guidance on dose

or

follitropin beta: consult specialist for guidance on dose

Consider – assisted reproductive technology (ART)

Back
ONGOING
|
desiring fertility currently: secondary hypogonadism
Consider – 

assisted reproductive technology (ART)

Treatment recommended for SOME patients in selected patient group

Techniques such as in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) involve the administration of hormonal treatment to the female partner to stimulate ovarian follicle growth. Eggs are collected, fertilized, then reimplanted (embryo transfer) into the uterus. See Male factor infertility.

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Choose a patient group to see our recommendations

Please note that formulations/routes and doses may differ between drug names and brands, drug formularies, or locations. Treatment recommendations are specific to patient groups. See disclaimer

Use of this content is subject to our disclaimer