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Clinical experiences of HCG/HMG therapy for 100 cases of idiopathic male sterility were studied. Counts, motility rate of sperms were observed during the therapy. Nineteen cases revealed normal spermatogram (group 1), 31 cases revealed improved but not normal spermatogram (group 2) and 50 cases did not changed in the spermatogram (group 3). Sixteen pregnancies were found, in whom II cases belonged to group 1 and 5 cases belonged to group 2. For serum level of FSH measured before therapy, groups 2 and 3 were significantly higher than group 1, but for serum level of LH no significant differences in each three groups were found. The volumes of bilateral testicles measured before therapy in groups 2 and 3 were significantly smaller than those of group 1. From above findings, for cases of idiopathic male sterility HCG/HMG therapy were thought to be effective and serum level of FSH and volumes of bilateral testicles were thought to be good indicators to know the prognosis offertility.

A 37-year-old man, with complaints of abdominal mass and left flank pain, was admitted and radical orchiectomy on the right side was performed under the diagnosis of right testicular tumor metastasizing onto left retroperitoneal space. The histology of the testicular tumor revealed seminoma and mature teratoma. Through exploratory laparotomy, the tumor was found involving both ureter and common iliac vessels. Biopsy from the retroperitoneal mass showed mature teratoma quite similar with the finding of the testicular tumor but without any seminomatous pattern. Literature was reviewed briefly.

A 25-year-old Japanese man was admitted with complaints of painless swelling of a right scrotal content and an abdominal mass. A right high orchiectomy was performed under the diagnosis of right testicular tumor metastasizing into retroperitoneal space. The histological examination of the primary testicular tumor revealed mature teratoma. Then, exploratory laparotomy was performed, but radical dissection of the retroperitoneal tumor was not done because it involved both aorta and inferior vena cava. Biopsy showed seminoma accompanied with yolk sac tumor. Literature was reviewed concerning histopathological difference between primary and metastasizing tumor of the testis.

HCG and HMG were administered for idiopathic male sterilities (noneunuchoidal hypospermatogenesis) to evaluate the change of the sperm counts. 161 cases were divided into four groups (groups 1-4) and between each group no significant differences exsisted in volume of testicle and levels of serum LH, FSH and testosterone. In group 1, which consisted of 17 cases of azoospermia and 16 cases of oligozoospermia (lower than 30×10ml), 5, 000 IU of HCG was administered one time a week, in group 2, which consisted of 33 cases of azoospermia and 50 cases of oligozoospermia, 3, 000 IU of HCG and 75 IU of HMG were administered each one time a week, in group 3, which consisted of 14 cases of azoospermia and 16 cases of oligozoospermia, 3, 000 IU of HCG and 75 IU of HMG were administered one time and three times a week respectively and in group 4, which consisted of 5 cases of azoospermia and 10 cases of oligozoospermia, 75 IU of HMG was administered three times a week. Each regimen was continued from three to fourteen months. For results of therapy, 7 cases (21 %), 34 cases (41 %), 20 cases (66%) and 2 cases (13%) showed increases of sperm counts in each group. In all groups, cases of oligozoospermia had more responses than these of cases of azoospermia.

A 21-year-old man, who had had normal sexuality, noticed a decrease in libido and potency as well as loss of ejaculation. Endocrinological evaluation showed normal serum levels of gonadotropins but a low testosterone level. The response to clomiphene citrate was poor while the response to luteinizing hormone-releasing hormone and human chorionic gonadotropin were within normal limits. By the examination of brain computerized tomography a tumor was detected in the septum pellucidum and was resected. Histologically it proved to be a mixed tumor composed of astrocytoma and oligodendroglioma. Two months after the operation the patient had recovered normal sexual functions and the endocrinological functions, including the responsiveness to clomiphene citrate, had been restored. This case suggests the existence of some stimulatory fiber for the secretion of luteinizing hormone in the septum pellucidum.