Follicle-Stimulating Hormone (FSH) Action on Spermatogenesis: A Focus on Physiological and Therapeutic Roles

Abstract

Background: Human reproduction is regulated by the combined action of the follicle-stimulating hormone (FSH) and the luteinizing hormone (LH) on the gonads. Although FSH is largely used in female reproduction, in particular in women attending assisted reproductive techniques to stimulate multi-follicular growth, its efficacy in men with idiopathic infertility is not clearly demonstrated. Indeed, whether FSH administration improves fertility in patients with hypogonadotropic hypogonadism, the therapeutic benefit in men presenting alterations in sperm production despite normal FSH serum levels is still unclear. In the present review, we evaluate the potential pharmacological benefits of FSH administration in clinical practice. Methods: This is a narrative review, describing the FSH physiological role in spermatogenesis and its potential therapeutic action in men. Results: The FSH role on male fertility is reviewed starting from the physiological control of spermatogenesis, throughout its mechanism of action in Sertoli cells, the genetic regulation of its action on spermatogenesis, until the therapeutic options available to improve sperm production. Conclusion: FSH administration in infertile men has potential benefits, although its action should be considered by evaluating its synergic action with testosterone, and well-controlled, powerful trials are required. Prospective studies and new compounds could be developed in the near future.

Infertility: Practical Clinical Issues for Routine Investigation of the Male Partner

“…This is already suggested for the screening of tens of genes implicated in hypogonadotropic hypogonadism [1,21]. Finally, pharmacogenetic tests for FSH treatment (polymorphisms in FSHB and FSHR genes) are promising but not yet applicable routinely on clinical practice [34][35][36][37].…”

Glycoprotein G-protein Coupled Receptors in Disease: Luteinizing Hormone Receptors and Follicle Stimulating Hormone Receptors

“…FSH, either alone or in preparations containing hormone mixtures, is used to drive the development of multiple follicles in in vitro fertilization protocols that are customized to reflect women’s age and naturally occurring FSH levels [ 41 ]. In males, FSH, either alone or in combination with hCG, can be used to treat hypogonadotropic hypogonadism and stimulate spermatogenesis [ 42 ], although patient groups have been comparatively small and this pharmacologic use of FSH has varying degrees of efficacy [ 43 ].…”

Hirntodkriterium und Organspende: aktuelle neurowissenschaftliche Perspektive

“…Dann muss der regelhafte Ausfall der Hypophysenfunktion mittels Hormongaben ausgeglichen werden (obligat Hydrocortison, evtl. Schilddrüsenhormone, Vasopressin), um Stoffwechsel und Herz-Kreislauf-Funktion zu stabilisieren [46,47] [45]). Das in der Hypophyse gebildete luteinisierende Hormon (LH) hat eine noch entscheidendere Rolle bei der Spermatogenese, und zwar über die Stimulation der Testosteronproduktion in den Leydig-Zellen im Hoden.…”

“…Nach Eintritt des Hirntodes kommt es bei fortgeführter Beatmung und dadurch noch aufrechterhaltener Herz-Kreislauf-Funktion innerhalb weniger Tage zu einem deutlichen Abfall der Produktion des follikelstimulierenden Hormons (FSH) im Hypophysenvorderlappen [ 44 ]. Bei der Frau sind ausreichende FSH-Spiegel zwingend erforderlich für die Reifung der Eizellen in den Ovarien [ 45 ]; der FSH-Abfall im Hirntod führt somit zwangsläufig zur weiblichen (biologischen) Unfruchtbarkeit [ 3 ].…”