Hypogonadotropic hypogonadism (HH) is a group of disorders caused by a lack or reduction in the production of hypothalamic gonadotropin-releasing hormone (GnRH) or pituitary gonadotropins. HH causes a decrease in the synthesis of sex hormones and manifests as delayed or absent puberty in children with prepubertal onset and hypogonadism and/or infertility in patients with adult onset. the etiology of HH can usually be divided into two categories: congenital and acquired. Patients with congenital HH are characterized by impaired GnRH secretion, which can be subdivided into idiopathic hypogonadotropic hypogonadism (IHH) and HH associated with olfactory disturbances (i.e., Kallmann syndrome). The incidence of the disease is approximately 1-10/100,000 live births, of which approximately 2/3 are in Kallmann syndrome [1]. Mutations in several loci, including KAL-1, FGR1 and GNRHR, are associated with the development of the disease. Acquired HH, on the other hand, is often one of the manifestations of the presence of substantial lesions such as trauma and tumors in the hypothalamic-pituitary axis. Jin Nan, Department of Endocrinology, 301 Hospital, Beijing, China There are usually three treatment options for HH: 1. Sex hormone replacement therapy: i.e. testosterone replacement therapy, or sequential estrogen-progestin therapy. Replacement therapy is suitable for all causes of hypogonadism and can enable patients to obtain and maintain secondary sexual characteristics, but its disadvantage is that it cannot induce gamete production and cannot achieve reproductive function.2. Gonadotropin therapy: usually applied with human chorionic gonadotropin (hCG) combined with human menopausal gonadotropin (HMG) or hCG combined with follicle stimulating hormone (FSH). It is indicated for patients with hypothalamic or pituitary lesions and promotes the synthesis of gonadotropic hormones, allowing the patient to acquire and maintain secondary sexual characteristics, while inducing the maturation of germ cells for reproductive function.3. GnRH pulse therapy: currently mostly performed by programmable, portable mini-pumps, continuous pulsed administration of GnRH analogs causes the pituitary gland to produce near-normal pulses of gonadotropins, thereby inducing gonadal development, producing sex hormones and promoting germ cell maturation. Most male patients require treatment for at least 2 years to maximize testicular volume and achieve sperm production. In patients with hypothalamic lesions resulting in HH, this treatment regimen most closely resembles the normal physiological state, but is only indicated for patients with normal pituitary function.