Treatment of idiopathic oligozoospermia with recombinant human follicle‐stimulating hormone: a prospective, randomized, double‐blind, placebo‐controlled clinical study in Chinese population

Ding, Yinman; Zhang, Xinji; Li, Jingping; Chen, Sansan; Zhang, Ren-tao; Tan, Wanlong; Shi, Xiaojun

doi:10.1111/cen.12770

Cited by 53 publications

(41 citation statements)

References 23 publications

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“…The FSH prescription recorded in this survey reflects the AIFA suggestion, although empirical. It is possible that higher doses/longer durations might be more effective . This is also suggested by a recent meta‐analysis, considering five randomized clinical trials, although based on a low number of patients (372 treated with FSH and 294 non‐treated) .…”

Section: Discussionmentioning

confidence: 95%

Use of follicle‐stimulating hormone for the male partner of idiopathic infertile couples in Italy: Results from a multicentre, observational, clinical practice survey

et al. 2020

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Background:The management of male idiopathic infertility is heterogeneous.Although meta-analyses reported the effectiveness on pregnancy rate, the real clinical impact of follicle-stimulating hormone (FSH) was not evaluated so far. In Italy, FSH is approved by the National Medicines Agency (AIFA) for idiopathic infertile patients with FSH < 8 IU/L, independently of semen parameters.Aim: Primary endpoint was to record the therapeutic approach to the male partner of infertile couples. Secondary aim was to assess changes of semen parameters during FSH treatment. Methods:A multicentre, prospective, observational, clinical practice survey was carried out, enrolling the male partner of infertile couples attending ten Italian participating centres. Inclusion criteria were as follows: couple infertility, age >18 years and FSH serum levels <8 IU/L. Thus, all men in which AIFA allowed the FSH prescription were enrolled. Primary endpoint was the number of infertile patients treated with FSH. Secondary outcomes were semen parameters. The treating physician decided whether to offer FSH therapy and whether to re-evaluate the male partner. Results:A total of 718 infertile couples were enrolled, and 241 patients were reevaluated (median follow-up: 4.5 months). In 64.9% (466 patients), a treatment was prescribed. FSH was prescribed in 397 patients (85.2% of treated men). Sperm concentration (P = .002) and normal form percentage (P < .001) significantly improved during FSH administration. No correlation was found between these parameters and FSH duration (P = .545 and P = .627, respectively) or dosage (P = .455 and P = .533, respectively). Among patients treated with FSH, the incidence of oligozoospermia decreased from 73.0% to 56.0% (P < .001) and teratozoospermia from 43.6% to 27.7% (P < .001).Discussion: This first nation-wide survey reveals a FSH prescription rate of 55% in patients qualifying for treatment according to AIFA. Although the study was not designed to highlight FSH efficacy in male infertility, a slight increase in semen parameters was demonstrated in about half of the treated men without adverse events. K E Y W O R D Sfollicle-stimulating hormone, FSH, male idiopathic infertility, open registry

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Section: Discussionmentioning

confidence: 95%

Use of follicle‐stimulating hormone for the male partner of idiopathic infertile couples in Italy: Results from a multicentre, observational, clinical practice survey

et al. 2020

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“…Paradisi et al 74,75 and Ding et al 76 have observed in placebo-controlled studies that a high dose of recombinant FSH (300 IU every other day for ≥4-5 months), instead of the standard dose of 75 IU/every other day, significantly increased sperm counts and pregnancy rates.…”

Section: Pharmacological and Genetic Amplification Of Fsh Action: Effmentioning

confidence: 99%

A short evolutionary history of FSH-stimulated spermatogenesis

Huhtaniemi¹

2015

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It is well established in various experimental models that luteinizing hormone (LH) stimulated testosterone (T) production of Leydig cells is the key endocrine stimulus of spermatogenesis.The role of the other gonadotrophin, follicle-stimulating hormone (FSH), is as yet somewhat unclear given that several clinical conditions and experimental models, including men with inactivating FSH receptor (R) mutation and male Fshb and Fshr knockout mice, maintain fairly normal spermatogenesis and fertility. Furthermore, FSH treatment of male infertility has produced at best modest results. On the other hand, there are animal species (e.g. teleost fishes and the Djungarian hamster) where spermatogenesis is primarily FSH-dependent. The purpose of this article is to briefly review the gonadotrophin dependence of spermatogenesis in several model species and examine how it has shifted during evolution from FSH to LH dominance. The information may provide new insight into the role of FSH treatment of male infertility.

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“…Clinical studies in idiopathic infertile men suggested sperm production dependency on the FSH dose [119,120], providing a rationale for optimizing the clinical approaches to the disease, which are currently mostly empirical. Indeed, data from the clinical studies indicated that the use of FSH would not be beneficial in about half of the patients.…”

Section: Fsh Use In Idiopathic Infertility: State-of-the-artmentioning

confidence: 99%

FSH for the Treatment of Male Infertility

Casarini

Crépieux

Reiter

et al. 2020

IJMS

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Follicle-stimulating hormone (FSH) supports spermatogenesis acting via its receptor (FSHR), which activates trophic effects in gonadal Sertoli cells. These pathways are targeted by hormonal drugs used for clinical treatment of infertile men, mainly belonging to sub-groups defined as hypogonadotropic hypogonadism or idiopathic infertility. While, in the first case, fertility may be efficiently restored by specific treatments, such as pulsatile gonadotropin releasing hormone (GnRH) or choriogonadotropin (hCG) alone or in combination with FSH, less is known about the efficacy of FSH in supporting the treatment of male idiopathic infertility. This review focuses on the role of FSH in the clinical approach to male reproduction, addressing the state-of-the-art from the little data available and discussing the pharmacological evidence. New compounds, such as allosteric ligands, dually active, chimeric gonadotropins and immunoglobulins, may represent interesting avenues for future personalized, pharmacological approaches to male infertility.

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Treatment of idiopathic oligozoospermia with recombinant human follicle‐stimulating hormone: a prospective, randomized, double‐blind, placebo‐controlled clinical study in Chinese population

Abstract: The efficacy of FSH treatment was associated with the dose of FSH and duration of treatment, and FSH therapy was more effective in patients with normal level and low level of inhibin B.

Cited by 53 publications

References 23 publications

Use of follicle‐stimulating hormone for the male partner of idiopathic infertile couples in Italy: Results from a multicentre, observational, clinical practice survey

Use of follicle‐stimulating hormone for the male partner of idiopathic infertile couples in Italy: Results from a multicentre, observational, clinical practice survey

A short evolutionary history of FSH-stimulated spermatogenesis

FSH for the Treatment of Male Infertility

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