To study the efficacy of rhFSH treatment on male infertility we evaluated the response of 79 hypo-normogonadotrophic patients referring to our clinic for couple infertility after a period of not <1218 months of finalized unprotected intercourse without conception. rhFSH 150 IU were given subcutaneously every other day for 12 months (mean 15±3 months). All men, between 23 and 56 years (mean 34±8 years), were divided into three subgroups: i) hypogonadotropic hypogonadism with hypopituitarism (n=24), ii) functional hypogonadotropic hypogonadism (n=40), iii) hypogonadism associated with other conditions (n=16: betathalassemia, testicular dysgenesis syndrome, adrenogenital syndrome). FSH levels were in the low-normal range (5.9±2.8 mU/ml) in all patients. Testosterone and LH serum levels and testicular volume were compared before and after treatment in all groups. According to WHO standards the total number of sperms (NTS), the sperm morphology and motility were assessed. After hrFSH treatment, there was no significant change in either values of testosterone and LH (respectively 4.3±1.2 ng/ml and 3.5±1.8 mU/ml), or testicular volume (Prader 18±5). hrFSH treatment induces in group B a significant improvement in sperm number (NTS from 4.1±3.0 to 15.0±12.0 mln, P<0.002) and motility (23 vs 35%, P> 0.03), while there was no effect on sperm morphology. Males in the group A, completely azoospermic before treatment, had a weak response of NTS (up to 4.2±2 mln, in 25% of patients) after treatment. In group C there was no significant results. In conclusion rhFSH treatment in males with functional hypogonadotropic hypogonadism induces a marked increase in sperm count, a slight increase in sperm motility, no change in sperm morphology. Our preliminary data shows that rhFSH prolonged treatment can cause a noticeable improvement especially in those males with functional forms of hypogonadotropic hypogonadism.
30 Apr - 04 May 2011
European Society of Endocrinology