Abstract
Scientific evidence shows that the administration of follicle-stimulating hormone (FSH) to infertile patients with normal serum FSH concentrations improves sperm parameters in oligozoospermic men. The aim of this study was to evaluate the effects of highly purified urofollitropin (hpFSH) on conventional and bio-functional sperm parameters and on oxidative stress indices in patients with idiopathic infertility. We also evaluated the response to hpFSH on these parameters in relationship to FSHR c. 2039 A/G and FSHR c. -29 G/A genotypes. A prospective longitudinal study was conducted on 42 patients with idiopathic male infertility, 23 of whom underwent to FSHR c. 2039 A/G and FSHR c. -29 G/A genotyping. Each patient was asked to collect two semen samples before and after administration of 150 IU hpFSH three times a week for 16 weeks. Patients were divided into responders or non-responders based on whether their total sperm count had at least doubled or was less than double at the end of treatment, respectively. Responders showed a significantly higher semen volume, sperm concentration, spermatids, and leukocytes. Non-responders had a significant decrease of the percentage of spermatozoa in early apoptosis after hpFSH administration. Oxidative stress indexes did not differ significantly after FSH administration in both groups. Conventional and bio-functional sperm parameters did not differ in patients with FSHR c. 2039 GG and AA genotypes, and FSHR c. -29 GG genotype both before and after FSH administration. The FSHR c. 2039 and FSHR -29 G/A genotypes and allelic distribution did not differ between responders and non-responders. FSH showed to be capable of ameliorating sperm parameters in about half patients treated, therefore it may be helpful in patients with idiopathic infertility.
Highlights
The therapeutic effects of follicle-stimulating hormone (FSH) on spermatogenesis are well known
A prospective longitudinal study was conducted on 42 patients with idiopathic male infertility, 23 of whom underwent to FSHR c. 2039 A/G and FSHR c. -29 G/A genotyping
FSH treatment could be useful for its role in stimulating spermatogenesis and mitotic and meiotic DNA synthesis, there is no conclusive data about beneficial efficacy for the treatment of male idiopathic infertility
Summary
The therapeutic effects of follicle-stimulating hormone (FSH) on spermatogenesis are well known. Scientific evidences show that the administration of FSH (both extractive purified FSH (pFSH) or recombinant FSH (rFSH)) to infertile patients with normal serum FSH concentrations, improve sperm parameters in oligozoospermic men and increase fertilization and pregnancy rates [1,2,3]. Some studies did not find significant effects of FSH on conventional sperm parameters, but showed an improvement of the degree of sperm DNA fragmentation [5,6,7], a decrease of the aneuploidy rate, and an increase in oocyte fertilization rate. Several single nucleotide polymorphisms (SNPs) have been currently identified in the FSHR and FSHβ genes. It is known that the effectiveness of FSH therapy is modulated by polymorphisms of the FSHR [8] and FSHβ [9] genes. The analysis of these polymorphisms could be helpful in identifying the possibly responders to the treatment
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