Fig. 3

Management optimisation of male patients with hereditary hemochromatosis. In patients presenting increased Ferritin ≥300 μg/L, with or without clinical manifestations, investigations should be provided including a hormonal check-up. In case of abnormal sex hormone concentrations, phlebotomy weekly should be proposed alone if patients are younger than 40, systematically associated with gonadotrophin treatment if 40 or older. According to cases reported in the literature, we also recommend a systematic replacement therapy with gonadotropin associated with phlebotomy in infertile hereditary hemochromatosis patients until they obtained the desired child. Finally, before stopping the replacement therapy and returning to a less intense rhythm of phlebotomy, cryopreservation of spermatozoa is offered to them