The effect of pure FSH administration in non-obstructive azoospermic men on testicular sperm retrieval

AYDOS K., Unlu C., Demirel L., Evirgen O., Tolunay O.

EUROPEAN JOURNAL OF OBSTETRICS GYNECOLOGY AND REPRODUCTIVE BIOLOGY, vol.108, no.1, pp.54-58, 2003 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 108 Issue: 1
  • Publication Date: 2003
  • Doi Number: 10.1016/s0301-2115(02)00412-8
  • Journal Name: EUROPEAN JOURNAL OF OBSTETRICS GYNECOLOGY AND REPRODUCTIVE BIOLOGY
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Page Numbers: pp.54-58
  • Keywords: histopathology, non-obstructive azoospermia, pure FSH/TESE, testicular spermatozoa, FOLLICLE-STIMULATING-HORMONE, NONOBSTRUCTIVE AZOOSPERMIA, MALE-INFERTILITY, EXTRACTION, INJECTION, SPERMATOGENESIS, SPERMATOZOA, BIOPSY, CELLS, FERTILIZATION
  • Ankara University Affiliated: No

Abstract

Background: In cases of azoospermia due to impaired spermatogenesis, spermatozoa can be retrieved by sperm extraction (TESE) from testicular biopsy. Objective: To evaluate the efficacy of pure follicle-stimulating hormone (pFSH) on sperm recovery, and measure the predictive value of testicular histology. Study design: In all; 108 patients were studied. These included those with Sertoli cell-only (n = 16), focal spermatogenesis (n = 36), maturation arrest (n = 19) and hypospermatogenesis (n = 37) in previous explorative biopsies. All had normal serum FSH, LH and testosterone levels. In 63 cases, 75IU pFSH were administered, either i.m. or s.c., three times a week, for 3 months and the control group (n = 45) no treatment was given. Results: The sperm retrieval rate was 64% (40/63 pts.) in pFSH treated men versus 33% (15/45 pts.) in controls (P < 0.01). In Sertoli cell-only patients, the rate was 2/7 (28%) versus 4/9 (44%) in controls and treated men, respectively (P > 0.05); and 3/8 (37%) versus 5/11 (45%) in maturation arrest (P > 0.05); 6/14 (42%) versus 18/23 (78%) in hypospermatogenesis (P < 0.05); and 4/16 (25%) versus 13/20 (65%) in focal spermatogenesis (P < 0.01). Treatment with pFSH also improved the quantity of retrieved spermatozoa compared to control values (P < 0.05). Conclusion: pFSH treatment improves the success of TESE for non-obstructive azoospermic men with normal FSH levels. (C) 2002 Elsevier Science Ireland Ltd. All rights reserved.