EYES2023 ESE Young Endocrinologists and Scientists (EYES) 2023 Oral communication 5: Reproductive Endocrinology (9 abstracts)
Follicle stimulating hormone in male idiopathic infertility: How to predict its efficacy?
Marilina Romeo 1 , Giorgia Spaggiari 2 , Leonardo Dalla Valentina 3 , Federico Nuzzo 4 , Laura Roli 5 , Maria Cristina De Santis 5 , Tommaso Trenti 5 , Antonio R. M. Granata 2 , Manuela Simoni 3 & Daniele Santi 6
1University of Modena and Reggio Emilia, Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, Modena, Italy, Department of Biomedical, Metabolic and Neural Sciences, Modena, Italy; 2Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, Modena, Italy, Unit of Andrology and Sexual Medicine of the Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, Modena, Italy, Italy; 3Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy., Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, Modena, Italy, Italy; 4Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy, Italy; 5Department of Laboratory Medicine and Pathology, Azienda Usl of Modena, Modena, Italy, Italy; 6Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy, Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, Modena, Italy, Italy.
Background: Testis stimulation with follicle stimulating hormone (FSH) is one of the empirical treatments proposed for male idiopathic infertility, although early reliable markers to predict its efficacy are still lacking.
Objective: To identify the improvement of semen parameters required to predict a priori FSH efficacy in terms of pregnancy achievement.
Methods: A real-world study was conducted, enrolling idiopathic infertile men treated with FSH 150IU 3 times weekly. According to the Italian rules, patients were treated until pregnancy achievement, or for a maximum of 2 years. For each patient, 2 visits were considered: V0 (baseline) and V1 (end of FSH treatment). Semen parameters were collected at both visits and their percentage changes after FSH therapy were calculated. Primary endpoints were the V1-V0 percentage of sperm concentration, total sperm count and total motile sperm number. Pregnancies were recorded, dividing the dataset in study (pregnancy gained) and control groups (no pregnancy).
Results: 48 pregnancies were recorded (27.7%) among 173 men (age 37.9±6.2 years, FSH duration 8.0±4.5 months). All 3 endpoints increased after FSH administration, although the V1-V0 percentage did not differ between study and control groups. Logistic regression analysis showed that only V1-V0 percentage of sperm concentration significantly predicted pregnancy (Wald 7.392, P=0.007). The second order polynomial function described the sperm concentration V1-V0 percentage (Y) needed to obtain a pregnancy according to its baseline values (x): Y=9.8x2–203.7x+958.3.
Conclusion: Our study demonstrated that only the percentage increase of sperm concentration after FSH administration could predict the treatment efficacy in terms of pregnancy. The application of mathematical analyses on data distribution identified for the first time a function able to predict the sperm concentration increase needed to obtain a pregnancy in relation to the baseline sperm number.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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