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This combination hormonal therapy regimen consists of goserelin (a GnRH agonist), human chorionic gonadotropin (hCG), and human menopausal gonadotropin (hMG). Developed and studied by Jinling Hospital in China, this specific protocol is designed for the treatment of non-obstructive azoospermia (NOA). The strategy involves an initial phase of pituitary-gonadal axis suppression using goserelin to down-regulate endogenous gonadotropin levels, which are often pathologically elevated in NOA patients. This is followed by the sequential administration of hCG and hMG to directly stimulate the Luteinizing Hormone (LH) and Follicle-Stimulating Hormone (FSH) receptors in the testes. The goal of this 'reset and stimulate' approach is to induce spermatogenesis or improve the microenvironment for sperm production, thereby increasing the success rate of viable testicular sperm retrieval for assisted reproduction.
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