Infertility in Pws

A better word is infertile....the word “sterile” has negative connotations. On a purely theoretical level, males with PWS should be able to correct their infertility if they receive gonadotropin replacement or if we knew of a way to restore endogenous gonadotropin secretion. The testicles are generally normal (except in cases of testicular damage due to maldescent and/or surgical damage) However, in practice, it is rather difficult to correct gonadotropin deficiency in males. This is true in other situations of male hypogonadotropic hypogonadism, not only PWS. The reasons for this are complex, but basically have to do with the need for pulsatile gonadotropin secretion, which is difficult to replicate using medications. Some andrology clinics have had limited success using gonadotropin pump therapy in cases of hypogonadotropic hypogonadism, but I am not aware of any attempts in males with PWS. We now also recognize the importance of other hormones, such as inhibin and activin, in the control of male fertility, but I am not aware of any studies specifically looking at these hormones in PWS.