Hopeful boy with hypogonadism looking at a field of wheat symbolizing sperm.

Can FSH Treatment Jumpstart Fertility in Boys with Hypogonadism? New Hope for Future Dads

Lena Kashyap in Health & Wellness November 2025 • 4 min read.

"A new study sheds light on how early FSH treatment can make a difference for boys with severe congenital hypogonadotropic hypogonadism, offering a path to future fatherhood."

For adolescent boys facing congenital hypogonadotropic hypogonadism (CHH), the journey to adulthood often includes significant hurdles, especially when it comes to fertility. CHH, a rare genetic disorder, disrupts the body's ability to produce key hormones needed for sexual development. This can lead to delayed puberty and, later in life, challenges in conceiving a child.

Traditionally, testosterone treatments have been used to help these young men develop masculine characteristics. However, these treatments don't always address the underlying issues that affect sperm production. Now, emerging research suggests that early intervention with recombinant human Follicle-Stimulating Hormone (r-hFSH) could offer a more promising approach. By stimulating Sertoli cells, which play a crucial role in sperm production, r-hFSH aims to set the stage for improved fertility in the future.

A recent study published in the Journal of the Endocrine Society is providing new insights into this approach. Researchers have been investigating the effects of r-hFSH, human chorionic gonadotropin (hCG), and testosterone treatments on a small group of boys with severe CHH. Their findings offer a beacon of hope, suggesting that even in severe cases, early and strategic hormonal interventions can significantly improve the chances of future fertility.

Unlocking Fertility: How FSH Treatment Makes a Difference

Hopeful boy with hypogonadism looking at a field of wheat symbolizing sperm.

The primary goal of the study was to evaluate the impact of r-hFSH on boys with CHH, particularly focusing on how it affects testicular volume and hormone levels. Researchers conducted a retrospective review across three medical centers in Finland, gathering data from 2006 to 2016. The study included five boys with CHH, each diagnosed with a different genetic mutation affecting hormone production. Before treatment, these boys had small testicular volumes, ranging from 0.3 to 2.3 mL, and some had additional conditions like micropenis or a history of undescended testes.

The boys underwent various treatment protocols, including r-hFSH, hCG, and testosterone, both individually and in combination. The researchers closely monitored several key indicators throughout the treatment period, including:

Testicular Volume (TV): Measuring the growth and development of the testes.
Inhibin B Levels: Assessing Sertoli cell activity, which supports sperm production.
Anti-Müllerian Hormone (AMH): Monitoring Sertoli cell maturation.
Testosterone Levels: Tracking the development of male characteristics.
Sperm Count: Evaluating the ability to produce sperm.

The results of the study were encouraging. Treatment with r-hFSH led to a doubling of testicular volume and a significant increase in inhibin B levels. Further treatment with hCG led to even greater increases in testicular volume. Remarkably, two boys with extremely small testes at the start of the study were able to develop sperm, which was then cryopreserved for future use.

A Promising Future for Boys with Hypogonadism

This study provides strong evidence that early intervention with gonadotropins, particularly r-hFSH, can significantly improve the fertility potential of boys with severe CHH. Even in cases with extremely small testes, treatment can stimulate sperm production, offering hope for future fatherhood. The researchers emphasize the importance of considering gonadotropin treatment, alongside testosterone, in the management of CHH. By inducing puberty with gonadotropins, doctors can give young men with CHH the option to preserve their fertility, empowering them to make informed choices about their future.

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This article is based on research published under:

DOI-LINK: 10.1210/js.2018-00225, Alternate LINK

Title: Recombinant Human Fsh Treatment Outcomes In Five Boys With Severe Congenital Hypogonadotropic Hypogonadism

Subject: Endocrinology, Diabetes and Metabolism

Journal: Journal of the Endocrine Society

Publisher: The Endocrine Society

Authors: Ella Kohva, Hanna Huopio, Matti Hero, Päivi J Miettinen, Kirsi Vaaralahti, Virpi Sidoroff, Jorma Toppari, Taneli Raivio

Published: 2018-10-15

Everything You Need To Know

How does congenital hypogonadotropic hypogonadism (CHH) affect fertility, and how does recombinant human Follicle-Stimulating Hormone (r-hFSH) offer a different approach compared to traditional treatments?

Congenital hypogonadotropic hypogonadism (CHH) disrupts the body's ability to produce hormones essential for sexual development, potentially leading to delayed puberty and fertility challenges. Recombinant human Follicle-Stimulating Hormone (r-hFSH) is a treatment option that stimulates Sertoli cells, crucial for sperm production, aiming to improve future fertility. Unlike testosterone treatments, r-hFSH addresses the underlying issues affecting sperm production directly.

What specific methods were used to assess the impact of recombinant human Follicle-Stimulating Hormone (r-hFSH) on boys with congenital hypogonadotropic hypogonadism (CHH) in the study?

The recent study, published in the Journal of the Endocrine Society, focused on the effects of recombinant human Follicle-Stimulating Hormone (r-hFSH) in boys with congenital hypogonadotropic hypogonadism (CHH). Researchers monitored key indicators, including testicular volume, inhibin B levels (assessing Sertoli cell activity), Anti-Müllerian Hormone (AMH) (monitoring Sertoli cell maturation), testosterone levels, and sperm count. The goal was to evaluate how r-hFSH impacts testicular development and hormone levels in these boys.

What were the key results observed in the study regarding the impact of recombinant human Follicle-Stimulating Hormone (r-hFSH) on testicular volume and sperm production in boys with congenital hypogonadotropic hypogonadism (CHH)?

Treatment with recombinant human Follicle-Stimulating Hormone (r-hFSH) led to a doubling of testicular volume and a significant increase in inhibin B levels, indicating improved Sertoli cell activity. Subsequent treatment with human chorionic gonadotropin (hCG) further increased testicular volume. Notably, two boys with initially very small testes developed sperm, which was cryopreserved for future use, highlighting the potential of early intervention.

Besides recombinant human Follicle-Stimulating Hormone (r-hFSH) and testosterone, what other hormonal treatments are relevant in addressing congenital hypogonadotropic hypogonadism (CHH), and what specific roles do they play?

In addition to recombinant human Follicle-Stimulating Hormone (r-hFSH) and testosterone, human chorionic gonadotropin (hCG) plays a role. While r-hFSH stimulates Sertoli cells to initiate sperm production, hCG helps in further increasing testicular volume and supporting the overall development of the testes. The combined approach of r-hFSH and hCG has shown promising results in improving fertility potential in boys with congenital hypogonadotropic hypogonadism (CHH).

What are the broader implications of using recombinant human Follicle-Stimulating Hormone (r-hFSH) to improve fertility in boys with congenital hypogonadotropic hypogonadism (CHH), and how does this treatment empower individuals in their reproductive choices?

The study emphasizes that early intervention with gonadotropins, particularly recombinant human Follicle-Stimulating Hormone (r-hFSH), can significantly improve fertility potential in boys with severe congenital hypogonadotropic hypogonadism (CHH). This intervention allows young men with CHH the option to preserve their fertility, empowering them to make informed choices about their future and potentially father children. This approach offers a proactive way to manage CHH beyond traditional testosterone treatments.