Case Report: Successful Outcome of Primary Infertility with Multidrug Therapy in a Long-Standing Case of Hypogonadism Resulting from Lepromatous Leprosy: Shattering the Dogma of Irreversible Infertility in Leprosy

Abstract

ABSTRACT. We present a case of primary infertility with features of hypogonadism in a male patient with lepromatous leprosy who had remained undiagnosed for 3 years. On investigation, azoospermia and deranged gonadotropin levels with normal serum testosterone were noted and the patient was initiated on multibacillary–multidrug therapy with the primary aim of treating the disease. Although the cutaneous lesions improved within 6 weeks, remarkably infertility was reversed in 2 months—with concomitant normalization of luteinizing hormone, follicle stimulating hormone, and sperm count—an outcome that was unexpected. While reiterating leprosy as a cause of infertility, we discuss the probable mechanism for the efficacy of multidrug therapy in what seemed to be an irreversible outcome of advanced lepromatous leprosy.