Induction of spermatogenesis in men with hypogonadotropic hypogonadism.

PURPOSE: We compared our clinical experience to international standards, assessed by response to treatment and pregnancy rates to ensure our results were comparable. METHODS: Men presenting with azoospermia related to hypogonadism were recruited into a treatment programme which was managed by one person over 8 years in a secondary care facility. Treatment followed published management plans using urinary gonadotropins. Data were collected on success rates in spermatogenesis, as well as variables which might predict success, and costs. Statistical analysis used non-parametric methods. RESULTS: Of 16 men with HH, 14 achieved spermatogenesis, and 9 had sperm cryopreserved. Of those 14, 6 were successful in achieving a pregnancy with their partner from assisted conception (including ICSI) and one after natural conception. Factors identified to identify men likely to be successful in treatment were whether testicular volume was larger at onset of gonadotropins (median 10 mL) with a trend towards greater success if the cause developed after puberty. Mean treatment costs per man treated amounted to GP£4379/UD$5377 (figures for September 2020). Success rates from this treatment should exceed 70% in most clinical settings. The likelihood of success improves when testicular volume exceeded 10 mL at initiation of treatment and a trend exists whereby success is more likely whereby when hypogonadism developed after puberty. Treatment costs are at a level likely to benefit quality of life, supporting the delivery of this treatment and where necessary and possible, funding it in line with other fertility treatments. This treatment should be available much more widely as a management option for men with hypogonadism, allowing them to father a biological child, rather than using donor sperm.

Evaluation of acetone as organic modifier in SPE for bioanalytical quantitative LC-MS/MS.

BACKGROUND: To assess the suitability of acetone as an alternative to acetonitrile in SPE under otherwise commonly used conditions, with a focus on selectivity with regard to the most abundant phospholipid class. Two representative analytes were included, leuprolide and tramadol, a peptide and a small molecule, respectively. RESULTS: The use of acetone resulted in analogous elution profiles of all monitored compounds in the majority of conditions. The only significant difference was on silica-based C18, where acetone effected markedly enhanced elution of lysophosphatidylcholines than did acetonitrile. Unmodified silica was shown to operate in per aqueous LC mode in highly aqueous conditions. CONCLUSION: Acetone was established as a selectively similar and slightly more eluotropic alternative to acetonitrile in bioanalytical SPE.