Follicle-stimulating hormone treatment for men with idiopathic oligoteratoasthenozoospermia before in vitro fertilization: the impact on sperm microstructure and fertilization potential.
OBJECTIVE
To assess the effect of FSH on sperm fertilization potential and sperm intracellular structure in men with oligoteratoasthenozoospermia and a proven low fertilization rate in IVF.


METHODS
Prospective, randomized, partial crossover study.


METHODS
IVF Unit, Golda Campus, Rabin Medical Center, Petah Tikva, Israel.


METHODS
Forty normogonadotropic, normogonadal men with oligoteratoasthenozoospermia and at least one previous IVF attempt in which fertilization failed or the fertilization rate was <30%.


METHODS
The men were randomly assigned to treatment with daily injections of 75 IU of FSH or 150 IU of FSH for at least 60 days before IVF treatment. A control group of men underwent an IVF cycle without treatment and then were randomly assigned tojoin group 1A or 1B for an additional IVF cycle with treatment.


METHODS
LH, FSH, and testosterone levels during FSH treatment, evaluation of ultramorphologic changes in sperm by electron microscopy, and comparison of fertilization rates in the control and study groups.


RESULTS
After treatment with 75 IU or 150 IU of FSH, the mean fertilization rates were 19.7% and 20.5%, respectively, compared with a 5.8% fertilization rate in the study control cycles.


CONCLUSIONS
Prolonged treatment with FSH results in a significant increase in fertilization rates. This effect may be related to improvements in subcellular components of the sperm.
Ben-Rafael
Z
Z
Department of Obstetrics and Gynecology, Rabin Medical Center, Petah Tikva, Israel.
Farhi
J
J
Feldberg
D
D
Bartoov
B
B
Kovo
M
M
Eltes
F
F
Ashkenazi
J
J
D000177:Acrosome / Q000648:ultrastructure; D000293:Adolescent; D000328:Adult; D002467:Cell Nucleus / Q000648:ultrastructure; D018592:Cross-Over Studies; D005307:Fertilization in Vitro; D005640:Follicle Stimulating Hormone / Q000008:administration & dosage / Q000097:blood / Q000627:therapeutic use*; D006801:Humans; D007248:Infertility, Male / Q000628:therapy*; D007986:Luteinizing Hormone / Q000097:blood; D008297:Male; D008854:Microscopy, Electron; D008875:Middle Aged; D011446:Prospective Studies; D013094:Spermatozoa / Q000648:ultrastructure*; D013739:Testosterone / Q000097:blood
D013739:Testosterone; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone