Endocrine Abstracts

Follicle-stimulating hormone (FSH) therapy is a potential treatment option in idiopathic infertile men with normal FSH levels. In fact, a recent Cochrane meta-analysis showed that FSH treatment of men affected by idiopathic oligozoospermia significantly improves pregnancy rate. Hyaluronic acid (HA) binding capacity of spermatozoa is considered a marker of functional competency, consequently the evaluation of the percentage of HA bound spermatozoa in the ejaculate can serve as a proxy of sperm fertilizing potential.

Aim: 1) to study the effect of HP-FSH treatment on routine sperm parameters and on HA binding capacity of spermatozoa; 2) to evaluate the effect of FSHβ promoter variant in FSH responsiveness

Materials and methods: Thirty five idiopathic oligo- or asthenozoospermic men were included in the study with FSH<8 mU/ml. After routine sperm analysis, HA Binding assay have been performed by using coated slides with HA before, 1 and 3 months intra-therapy and after 4 months of wash out from the therapy. FSHβ promoter -211G>T was analyzed by Restriction Fragment Length Polymorphism (RFLP).

Results: After 3 months of HP-FSH treatment we observed a significant increase of the Total Motile Sperm Number (TMSN) (16.8±19.4 vs 31.1±26.7; P=0,000). 53% of patients resulted “responders“ (defined as an increase greater than the physiological oscillation) for TMSN. Similarly, the mean % of HA-bound spermatozoa showed a significant increase after one month (29.6%±13.6 vs 41.2%±19.7; P=0,000); 46% and 61% of patients resulted “responder“ with an average of two fold increase after 1 and 3 months, respectively. Although the distribution of the allelic frequencies of FSHB-211 between “responders” and “non-responders” did not result statistically different neither for HBA nor for TMSN, we observed a 100% responsiveness for TMSN in T/T genotype carriers.

Conclusion: Our study confirms that FSH therapy may improves spermatogenesis, both quantitatively and qualitatively in 53–61% of cases. For the first time, we report data showing a significant positive effect of FSH on a functional parameter, such as sperm HA binding already at 1 month i.e. during the phase called “spermiogenesis”.