Sperm quality of subfertile males before and after treatment with human follicle-stimulating hormone

Bartoov, B.; Eltes, F.; Lunenfeld, E.; Har‐Even, Dov; Lederman, Hanni; Lunenfeld, Bruno

doi:10.1016/s0015-0282(16)56653-9

Cited by 80 publications

(24 citation statements)

References 16 publications

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“…In fact, this sperm parameter reflects the degree of maturation, the morpho-structural, functional and genomic integrity of spermatozoa. Previous human studies demonstrated a positive effect of FSH therapy on ultrastructural sperm characteristics and DNA condensation (Bartoov et al, 1994;Baccetti et al, 1997Baccetti et al, , 2004Kamischke et al, 1998;Ben-Rafael et al, 2000;Piomboni et al, 2009). In fact, several experimental evidences support the concept that FSH in concert with Testosterone is essential also in the regulation of the latest phases of spermatogenesis.…”

Section: Discussionmentioning

confidence: 93%

Short‐term FSH treatment and sperm maturation: a prospective study in idiopathic infertile men

et al. 2017

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The standard FSH treatment is based on a 3 months period, after which both quantitative/qualitative improvement of sperm parameters and increased pregnancy rate were reported. In this prospective clinical trial, for the first time, we studied (i) Sperm hyaluronic acid binding capacity after highly purified FSH (hpFSH) treatment; (ii) the effect after short-term and standard treatment on this functional parameter. As secondary objective, we analyzed three SNPs on FSHβ and FSHR genes to define their potential predictive value for responsiveness. From a total of 210 consecutive patients, 40 oligo- and/or astheno- and/or teratozoospermic patients fulfilled the inclusion criteria. Treatment consisted in hpFSH 75 IU/L every other day for 3 months. To avoid potential biases derived from the lack of placebo, we analyzed each patient after 4-6 months of 'wash-out' period. After FSH treatment, we observed a statistically significant (p < 0.001) improvement of the percentage of hyaluronic acid bound spermatozoa from basal to T1 (after 1 month) and to T3 (after 3 months). Importantly, these values returned to near-baseline value after the wash-out. The same results were detected for total motile sperm count after 3 months with return to baseline after wash-out. Forty-two percent of patients responded to the therapy with increasing hyaluronic acid binding capacity above the double of the Intraindividual Variation (IV) while 24% of patients reached above the normal Sperm-Hyaluronan Binding Assay (HBA) value. Further increase in 'responders' was observed at T3. The responsiveness to treatment resulted independent from FSHR/FSHβ polymorphisms. The significant positive effect on sperm maturity after 1 month opens novel therapeutic perspectives. In view of both the high cost and the relative invasiveness of treatment, the short protocol (1 month) could represent a viable FSH treatment option prior Assisted Reproductive Techniques since FSH, by acting on sperm maturation, increases the proportion of functionally competent cells.

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Section: Discussionmentioning

confidence: 93%

Short‐term FSH treatment and sperm maturation: a prospective study in idiopathic infertile men

et al. 2017

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“…In these cases, the seminiferous tubules may still be able to produce reproductive hormones. In addition, it has been shown that men with normal reproductive hormone levels do not necessarily have normal reproductive hormone activity [34, 35]. Further studies are needed to confirm that translocations inducing meiotic arrest do not affect hormone levels or testicular volume.…”

Section: Discussionmentioning

confidence: 99%

Novel Y chromosome breakpoint in an infertile male with a de novo translocation t(Y;16): a case report

Jiang

Zhang

2012

J Assist Reprod Genet

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“…Following the impressive reports from uncontrolled trials of FSH in improving fertilization rates, an ultramicroscopy study showed a marked improvement in sperm organelles in u‐FSH treated men from an early (30 days) time‐point after treatment (Bartoov et al ., 1994). These findings were supported from a larger, controlled, long‐term FSH trial which also claimed that sperm ultramicroscopy had a predictive value for the outcome of treatment (Baccetti et al ., 1997).…”

Section: Prospects Of Medical Treatmentmentioning

confidence: 93%

“…In the wave of the initial enthusiasm after an uncontrolled trial which demonstrated impressive effectiveness (Acosta et al ., 1992), a number of subsequent (also uncontrolled) studies have shown that treatment with hp‐FSH or rec‐FSH increased markedly fertilization and pregnancy rates but not conventional sperm parameters (for reviews, see Adamopoulos, 1999; Kamischke & Nieschlag, 1999; Nieschlag et al ., 1999). This peculiar dissociation of biological responses was attributed to a rapid FSH induced improvement of sperm subcellular organelles (Bartoov et al ., 1994). Similar findings were observed later by an independent but uncontrolled study (Strehler et al ., 1997).…”

Section: Medical Treatmentmentioning

confidence: 99%

“…Moreover, its effective cumulative pregnancy rate after 1 year of treatment has been found to be similar to that of IVF‐treated couples (Comhaire et al ., 1995). In view of this situation, treatment with tamoxifen has been recently recommended as the first line of therapy for IO in the manual for the investigation and treatment of the infertile male issued by the WHO (2000). Obviously, further studies using pregnancy rate as an endpoint are required for this antioestrogen.…”

Section: Medical Treatmentmentioning

confidence: 99%

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Present and future therapeutic strategies for idiopathic oligozoospermia

Adamopoulos¹

2000

Int J of Andrology

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The effectiveness of medical treatment for idiopathic oligozoospermia (IO) has been at best doubtful until now and a logical consequence of this unsatisfactory situation has been the partial displacement of this approach by assisted reproduction techniques. This state of affairs has resulted from insufficient investigation, inappropriately designed clinical trials and consistent disregard for the principles of evidence-based medicine. Protocol-related shortcomings and wrong interpretation of the data available have also been some of the all too frequent problems encountered in this therapeutic approach. In this rather misty situation, it appears that, of the therapeutic agents used so far, follicle stimulating hormone (FSH) (mainly FSH-secretagogues) may exert some beneficial effects on a number of biological endpoints related to spermatogenesis and sperm maturation. The short and medium term prospects of medical treatment for IO rest mainly with improvement of investigative procedures to a higher degree of sophistication, with emphasis placed on identifying the causes rather than the results of dysfunction so that a better selection of candidates can be made. Moreover, the introduction of prognostic indices for evaluation of the beneficial effects of a therapeutic agent may be of paramount importance. Finally, a better assessment of the preparations available and, possibly, the introduction of new more specific agents may also be an important step forward in this field. This type of large-scale effort should not be left to individual investigators or special centres working independently, but it may come under the auspices of a central regulating agency so that undisputed results from large, multicentre and uniform studies might be obtained, if medical treatment is to remain a good option. In this context, it may also be emphasized that andrology's main task should always be to treat the male with the problem rather than his healthy female partner, whenever this is possible.

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Sperm quality of subfertile males before and after treatment with human follicle-stimulating hormone

Cited by 80 publications

References 16 publications

Short‐term FSH treatment and sperm maturation: a prospective study in idiopathic infertile men

Short‐term FSH treatment and sperm maturation: a prospective study in idiopathic infertile men

Novel Y chromosome breakpoint in an infertile male with a de novo translocation t(Y;16): a case report

Present and future therapeutic strategies for idiopathic oligozoospermia

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