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Standard protocol for hypogonadotropic hypogonadism: hCG 1500-2500 IU, 2-3x/week (Leydig/testosterone stimulation) Recombinant FSH 75-150 IU, 3x/week (direct spermatogenesis) Duration: 12-24 months typically Monitoring Seminal analysis every 3 months, testosterone monthly Success rate: Detectable sperm in 6080% cases LH/hCG receptor desensitization