title: Induction of spermatogenesis by rhFSH for azoospermia due to spermatogenic dysfunction with maturation arrest: five case series.
abstract: When sperm cannot be retrieved from the testes of patients with azoospermia due to spermatogenic dysfunction (ASD), there is no rational way for the patient to become a biological father. We investigated the possibility of inducing spermatogenesis in such patients by hormonal therapy with recombinant human follicle-stimulating hormone (rhFSH) alone. Twenty-six ASD patients who could not obtain spermatozoa by microdissection testicular sperm extraction (micro-TESE) were confirmed to have arrested spermatogenesis at the late stage of maturation arrest. They were subsequently treated with 75-150 IU two times/week rhFSH alone for 12 months. The primary endpoint was the appearance of sperm in ejaculate, and we followed the patients to determine the outcome of inseminating their partners. After rhFSH treatment, mature spermatozoa were found in the ejaculate in five of 26 (19.2%) patients, all of whom showed histology of non-uniform type maturation arrest. Intracytoplasmic sperm injection of the mature spermatozoa resulted in two ongoing clinical pregnancies (insemination success rate, 40.0%). Recombinant human follicle-stimulating hormone treatment can be used as an advanced assisted reproductive technology to improve spermatogenesis in some azoospermic patients with maturation arrest of spermatogenesis and is a potential treatment option after unsuccessful micro-TESE.
authors: Department of Urology, Dokkyo Medical University Koshigaya Hospital , Koshigaya , Japan.
authors: Yoshitomo
authors: Y
authors: Kobori
authors: Keisuke
authors: K
authors: Suzuki
authors: Toshiyuki
authors: T
authors: Iwahata
authors: Takeshi
authors: T
authors: Shin
authors: Ryo
authors: R
authors: Sato
authors: Kojiro
authors: K
authors: Nishio
authors: Hiroshi
authors: H
authors: Yagi
authors: Gaku
authors: G
authors: Arai
authors: Shigehiro
authors: S
authors: Soh
authors: Hiroshi
authors: H
authors: Okada
mesh_terms: D053713:Azoospermia / Q000188:drug therapy*; D005640:Follicle Stimulating Hormone / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D011994:Recombinant Proteins / Q000627:therapeutic use; D013091:Spermatogenesis / Q000187:drug effects*
chemical_list: D011994:Recombinant Proteins; D005640:Follicle Stimulating Hormone
keywords: Azoospermia; maturation arrest; recombinant human follicle-stimulating hormone; spermatogenesis