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The effectiveness of zinc supplementation in men with isolated hypogonadotropic hypogonadism


1 Shanghai Institute of Endocrinology and Metabolism, Department of Endocrinology and Metabolism, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
2 Department of Endocrinology, Drum Tower Hospital Affiliated to Nanjing University Medical School, Nanjing 210008, China
3 Department of Endocrinology, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou 510630, China
4 Department of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
5 Department of Endocrinology, Guangxi Medical University and First Affiliated Hospital, Nanning 530021, China
6 Department of Endocrinology, The First People's Hospital of Yunnan Province, Kunming 650032, China
7 Department of Endocrinology, The Affiliated Hospital of Guiyang Medical College, Guiyang 550004, China
8 Department of Endocrinology, General Hospital of Chinese People's Liberation Army, Beijing 100853, China
9 ,

Correspondence Address:
Da-Long Zhu,
Department of Endocrinology, Drum Tower Hospital Affiliated to Nanjing University Medical School, Nanjing 210008
China
Xiao-Ying Li,
Shanghai Institute of Endocrinology and Metabolism, Department of Endocrinology and Metabolism, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025
China
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Source of Support: None, Conflict of Interest: None

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 × 10 6 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.


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    -  Liu YL
    -  Zhang MN
    -  Tong GY
    -  Sun SY
    -  Zhu YH
    -  Cao Y
    -  Zhang J
    -  Huang H
    -  Niu B
    -  Li H
    -  Guo QH
    -  Gao Y
    -  Zhu DL
    -  Li XY
    -  on behalf of Hypogonadotropic Hypogonadism Intervention Study (HHIS) Group
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