ECEESPE2025 Poster Presentations Reproductive and Developmental Endocrinology (93 abstracts)
Testicular index: a simple, clinically applicable tool to predict pregnancy outcomes in men with idiopathic infertility undergoing follicle-stimulating hormone treatment
Giorgia Spaggiari 1 , Raffaele Scafa 2 , Giuseppe Grande 3 , Marilina Romeo 1,4 , Leonardo Dalla Valentina 1,4 , Andrea Graziani 2 , Antonio Raffaele Michele Granata 1 , Andrea Garolla 2,3 , Manuela Simoni 1,4 , Daniele Santi 1,4 & Alberto Ferlin 2,3
1Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, Modena, Italy; 2University of Padova, Department of Medicine, Padova, Italy; 3University Hospital of Padova, Unit of Andrology and Reproductive Medicine, Padova, Italy; 4Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
JOINT656
Background: Follicle-stimulating hormone (FSH) therapy has been shown to improve spermatogenesis, sperm quality, and reproductive outcomes. However, variability in patients’ response and limited data on pregnancy rate complicate its extensive application in male idiopathic infertility.
Aim of the Study: To identify predictors of FSH efficacy in men with idiopathic infertility in terms of pregnancy obtainment.
Materials and Methods: A multicenter, retrospective, observational study was conducted at two Italian outpatient clinics from June 2019 to October 2024. We enrolled men with idiopathic infertility and FSH serum levels < 8 IU/l treated with FSH. Data from two visits were analyzed: baseline (V0) and the final follow-up visit (V1) when FSH treatment was discontinued. Predictors of pregnancy achievement were searched among the data collected, such as semen parameters, hormonal levels, and testicular volumes. Different “testicular indexes” were calculated using V0 FSH and testosterone serum levels, bi-testicular volume and semen parameters.
Results: 443 men were included, of which 84 achieved pregnancy (19%). One testicular index ((FSH + Total testosterone) / bi-testicular volume) was directly related to V0 semen parameters and entered in subsequent analyses. Significant improvements in sperm concentration, motility, and total sperm count were observed following FSH treatment regardless of whether or not pregnancy was achieved. However, men who achieved pregnancy had higher baseline testicular index, larger testicular volume, and lower FSH levels. Multivariate analysis identified patients’ age and testicular index as significant predictors of pregnancy success.
Conclusion: This large, multicenter, real-life study identified a novel testicular index that predicts response to exogenous FSH stimulation, overcoming limitations of conventional semen analysis. The index assesses the interstitial compartment function (indicated by testosterone levels), spermatogenic potential (reflected by FSH levels), and target tissue amount (indicated by testicular volume). We demonstrate that low baseline testicular index correlates with a higher likelihood of achieving pregnancy through exogenous FSH stimulation.
Volume 110
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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