OR25-02 Hunting The Magic Bullet In Treating Male Secondary Hypogonadism Associated With Metabolic Syndrome: Results Of a Prospective Study Comparing Liraglutide Vs. Gonadotropins

Disclosure: S. La Vignera: None. R.A. Condorelli: None. A.E. Calogero: None. R. Cannarella: None. E. Greco: None. A. Aversa: None. Background: Previously, we hypothesized a role for glucagon-like peptide-1 (GLP1) analogs in the treatment of male infertility (DOI: 10.1111/andr.13015), although no studies have so far investigated this issue. Purpose: To prospectively investigate the effects of treatment with liraglutide, a GLP1 analog, on reproductive and sexual function in men with functional hypogonadism of childbearing age. Patients and Methods: 110 obese men of childbearing age (18-35 years) with functional hypogonadism were enrolled and divided into three groups based on their desire to have children. Group A consisted of men actively seeking paternity, Group B of men who did not seek paternity, and Group C of men who had already fathered a child. Group A was treated with gonadotropins [urofollitropin 150 IU three times a week and human chorionic gonadotropin (hCG) 2000 IU twice a week], Group B with liraglutide (3 mg daily), and Group C with transdermal testosterone (60 mg daily). The following endpoints were measured at enrolment and after 4 months: anthropometric and metabolic parameters, gonadotropins, total testosterone, conventional sperm parameters (Group A and B only), the score of the International Index of Erectile Function 5 Items (IIEF5), and frequency of phosphodiesterase type 5 inhibitors (PDE5i) use. Results: The groups did not differ on any of the baseline endpoints. Weight, body mass index, and waist circumference significantly decreased after treatment in Group B, but not in the other Groups. Liraglutide significantly increased LH (3.2±0.2 IU/L vs. 2.0±0.3 IU/L; p<0.01), FSH (2.6±0.2 IU/L vs. 1.6±0.3 IU/L; p<0.01), total testosterone (4.1±0.5 ng/mL vs. 1.4±0.6 ng/mL; p<0.05), and sex hormone-binding globulin (36.0±4.0 nmol/L vs. 14.0±3.0 nmol/L) levels from baseline, while no improvement was observed in the other Groups. Liraglutide increased sperm concentration (16±4 mil/ml vs. 6±2 mil/ml; p<0.05), progressive motility (34±4 % vs. 14±2 %; p<0.01), and morphology (10±2 % vs. 4±2 %; p<0.05), while treatment with gonadotropins only increased sperm progressive motility (19±2 % vs. 12±3 %; p<0.05) compared to baseline. The IIEF-5 score improved after liraglutide treatment (4±2 vs. 21±4; p<0.05), while no significant changes were observed in the other Groups. Similarly, PDE5i use decreased significantly in Group B (31%), compared with Groups A (48%) and C (45%). Conclusions: Liraglutide is an effective weight loss drug, which also improves serum gonadotropin and total testosterone levels, sperm conventional parameters, and sexual function in obese patients with functional hypogonadism seeking parenthood. This is the first study documenting the efficacy of liraglutide on the testicular function of these patients. Presentation Date: Saturday, June 17, 2023