Follicle-stimulating hormone bioactivity in idiopathic normogonadotropic oligoasthenozoospermia: double-blind trial with gonadotropin-releasing hormone.
OBJECTIVE
To identify, among patients with idiopathic normogonadotropic oligoasthenozoospermia, those with low bioactive follicle-stimulating hormone (FSH), possibly because of inadequate gonadotropin-releasing hormone (GnRH) pulsatility, whose bioactive FSH and sperm could be improved by GnRH treatment.


METHODS
Randomized, double-blind, placebo-controlled trial with intranasal (IN) GnRH, followed by open GnRH treatment.


METHODS
Outpatient endocrinology clinic.


METHODS
Twenty-eight infertile men with idiopathic normogonadotropic oligoasthenozoospermia.


METHODS
Gonadotropin-releasing hormone or placebo was self-administered IN every 2 hours.


METHODS
Serum immunoreactive and bioactive FSH and semen analyses.


RESULTS
Ten men showed a low basal FSH bioactive/immunoreactive ratio, which increased in 5 of them under GnRH without parallel sperm modification. Sperm improvements were observed in 10 patients with no parallel evolution of FSH bioactive/immunoreactive ratio. Unpredicted by sperm changes, three pregnancies developed on placebo and 5 on GnRH.


CONCLUSIONS
Low bioactive FSH was not the cause of idiopathic normogonadotropic oligoasthenozoospermia in our patients and could not predict response to GnRH. Pulsatile GnRH did not improve sperm beyond random fluctuations.
Crottaz
B
B
Department of Medicine, CHUV, Lausanne, Switzerland.
Senn
A
A
Reymond
M J
MJ
Rey
F
F
Germond
M
M
Gomez
F
F
D000281:Administration, Intranasal; D000328:Adult; D004311:Double-Blind Method; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood*; D007987:Gonadotropin-Releasing Hormone / Q000097:blood / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D009845:Oligospermia / Q000097:blood* / Q000188:drug therapy; D011247:Pregnancy; D011673:Pulsatile Flow; D011863:Radioimmunoassay; D013076:Sperm Count / Q000187:drug effects
D007987:Gonadotropin-Releasing Hormone; D005640:Follicle Stimulating Hormone