Clinical Use of FSH in Male Infertility

Abstract

The established clinical indication for FSH use in male infertility is the treatment of patients with hypogonadotropic hypogonadism for stimulation of spermatogenesis that allows the induction of a clinical pregnancy in the female partner and finally the birth of a healthy child. Several clinical studies with urinary, purified, and recombinant FSH preparations in combination with hCG have demonstrated the high treatment efficacy regarding these clinical endpoints. Shortcomings of this hormone therapy are the long duration of treatment, sometimes longer than 2 years, and the inconvenience of injections every second or third day. However, improvements of therapy might be expected with new hormonal treatment options already available for infertility treatment in the female. FSH use for treatment of patients with normogonadotropic idiopathic infertility and oligozoospermia is still considered experimental in most countries. Recent meta-analyses have shown that FSH can significantly increase pregnancy rates in the female partners of these patients, but the effect-size is relatively low. Therefore, predictive factors for treatment success have to be identified, including FSH pharmacogenetics, to select the right normogonadotropic patients with idiopathic infertility for FSH therapy.

FSH for the Treatment of Male Infertility

“…Biosimilars were developed after the patent of follitropin alpha and beta expired, and have a similar, albeit not identical molecular structure, and the same biological action as the originator [51]. The therapeutic employment of all these FSH preparations is mainly in the context of female infertility and assisted reproduction, while its use in the male is limited to hypogonadotropic hypogonadism [3]. FSH therapy in male idiopathic infertility is currently discussed [3] but no convincing evidence of its efficacy exists.…”

“…The therapeutic employment of all these FSH preparations is mainly in the context of female infertility and assisted reproduction, while its use in the male is limited to hypogonadotropic hypogonadism [3]. FSH therapy in male idiopathic infertility is currently discussed [3] but no convincing evidence of its efficacy exists.…”

“…Therefore, the nature of FSH action is different in the two genders, hence the clinical approaches to infertility [2]. To this purpose, a number of strategies and hormonal drugs were developed and used for the treatment of infertile women, while more efforts are necessary for optimizing therapy for male infertility [3]. In this review, we discuss the action of FSH, as well as its current use and perspectives for treating male infertility.…”

Membrane estrogen receptor (GPER) and follicle-stimulating hormone receptor heteromeric complexes promote human ovarian follicle survival

“…The proliferative role of FSH is well known, and indeed this hormone is used as a drug for inducing controlled ovarian stimulation and in the clinical setting of infertility treatment 60,61 .…”

Fertility Relevance Probability Analysis Shortlists Genetic Markers for Male Fertility Impairment

“…On the other hand, clarification of the genetic causes is a prerequisite for developing a tailored therapy of male fertility impairment [Sullivan, 2004;Bonache et al, 2012]. Yet, the long-term goal of a therapeutic offer is certainly desirable, regardless of alternatives such as in vitro fertilization and intracytoplasmic sperm injection [European IVF-Monitoring Consortium et al, 2016;Behre, 2019;Neuhaus and Schlatt, 2019]. After all, there are still many couples whose wish for a biological child is not being fulfilled despite medical attention.…”