Pituitary stalk interruption syndrome (PSIS) manifests as congenital multiple pituitary hormone deficiency. It is characterized by the absence of a pituitary stalk and dysplasia of the anterior lobe in magnetic resonance imaging.1 Gonadotropin deficiency is present in 96% of patients.2 These patients may complain of infertility, low/absent sexual desire, and erectile dysfunction if untreated.3

Pulsatile gonadotropin-releasing hormone (GnRH) and gonadotropin therapies can induce spermatogenesis, and are widely applied in hypogonadotropic hypogonadism patients who desire pubertal development and/or fertility.4 The efficiency and safety of the above 2 treatments have been confirmed in previous studies. Gonadotropin therapy is a combination of human chorionic gonadotropin (hCG) and human menopausal gonadotropin (hMG).5 Previous studies revealed that the success rate of spermatogenesis is 74% in patients with congenital hypogonadotropic hypogonadism (CHH) and 69% in patients with PSIS.6,7 Pulsatile GnRH therapy may activate the function of pituitary-gonadal axis. It is presumed that 60% of patients with PSIS respond well to pulsatile GnRH therapy.7

However, the efficiency of spermatogenesis by the 2 therapeutic methods has not been compared in patients with PSIS, and no consensus has been reached regarding what treatment should be preferred. Thus, the objective of this study was to compare the efficiency and long-term outcomes of pulsatile GnRH and hMG/hCG therapies in patients with PSIS.