POLG and Hypergonadotropic hypogonadism: Despite several reports of hypergonadotropic hypogonadism associated with POLG variants (115, 116) including a description of testicular atrophy (117) and an assertion that POLG contributes to at least 5% to 10% of cases of male infertility, spermatogenesis has conversely been demonstrated as normal across several studies (118-120).