Use of recombinant human follicle-stimulating hormone in the treatment of male factor infertility.
OBJECTIVE
To evaluate the effects of treatment with recombinant human FSH (r-hFSH) on seminal parameters and seminiferous epithelium in idiopathic patients with oligozoospermia with normal FSH plasma levels.


METHODS
Randomized single-blind study.


METHODS
Academic setting.


METHODS
Forty-five subjects with idiopathic oligozoospermia (sperm count <10 x 10(6)/mL) and normal FSH and inhibin B plasma levels.


METHODS
Three months of treatment with r-hFSH 50 IU (15 patients) or with r-hFSH 100 IU on alternate days (15 patients) or no treatment (15 patients); bilateral testicular fine-needle aspiration (FNA) performed before and after therapy; FSH and inhibin B plasma levels evaluated during treatment.


METHODS
Seminal parameters; testicular cytological features evaluated by FNA; plasma levels of FSH, LH, T, and inhibin B.


RESULTS
Treatment with r-hFSH at a dose of 50 IU induced no increase in sperm concentration, while treatment with r-hFSH at a dose of 100 IU induced a significant increase in sperm concentration. In particular, in 11/15 patients a doubling of the pretreatment sperm concentration was observed. No significant increase in sperm parameters was observed in the control group. In both groups of patients treated with r-hFSH, the cytological analysis before treatment showed hypospermatogenesis. An increase in the percentage of spermatogonia and spermatocytes was observed only after the treatment with r-hFSH at a dose of 100 IU.


CONCLUSIONS
The findings of this study demonstrate that r-hFSH at a dose of 100 IU, as previously seen with highly purified FSH, increases the spermatogonial population and sperm production in idiopathic patients with oligozoospermia with normal FSH and inhibin B plasma levels and a cytological picture of hypospermatogenesis.
Foresta
Carlo
C
Department of Medical and Surgical Sciences, Clinica Medica 3, University of Padova, Via Ospedale 105, 35128 Padua, Italy. forestac@protec.it
Bettella
Andrea
A
Merico
Maurizio
M
Garolla
Andrea
A
Ferlin
Alberto
A
Rossato
Marco
M
D001707:Biopsy, Needle; D005640:Follicle Stimulating Hormone / Q000097:blood / Q000494:pharmacology*; D006801:Humans; D007248:Infertility, Male / Q000188:drug therapy*; D007265:Inhibins / Q000097:blood; D007986:Luteinizing Hormone / Q000097:blood; D008297:Male; D009845:Oligospermia / Q000188:drug therapy*; D011994:Recombinant Proteins / Q000097:blood / Q000494:pharmacology; D012661:Semen / Q000166:cytology; D016037:Single-Blind Method; D013081:Sperm Motility / Q000187:drug effects / Q000502:physiology; D013739:Testosterone / Q000097:blood
D011994:Recombinant Proteins; C422364:inhibin B; D013739:Testosterone; D007265:Inhibins; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone