Recombinant human follicle-stimulating hormone as a pretreatment for idiopathic oligoasthenoteratozoospermic patients undergoing intracytoplasmic sperm injection

Abstract 

Objective

To evaluate the efficacy of recombinant human FSH pretreatment in improving fertilization and pregnancy rates in oligozoospermic patients who are undergoing ICSI.

Design

Prospective, controlled, clinical study.

Setting

A research institute's reproductive unit.

Patient(s)

Thirty-three subjects with idiopathic oligoasthenoteratozoospermia who failed to conceive after previous ICSI attempts.

Intervention(s)

Treatment with recombinant human FSH 150 IU for 3 months (23 patients) or no treatment (10 patients); clinical, hormonal, and seminal evaluation before and after treatment.

Main outcome measure(s)

Testicular volume, sperm parameters, FSH, LH, T, E₂, and inhibin B plasma levels, E/T ratio, and fertilization and pregnancy rates.

Result(s)

Treatment with 150 IU of FSH induced a significant increase in testicular volume and sperm parameters. The mean fertilization rate (FR) after ICSI cycles was higher, although not significantly, in treated patients when compared with controls (62.3 ± 22.4 vs. 47.2 ± 20.4). A strong negative correlation was observed between FR and serum FSH, inhibin B and E/T ratio in controls, whereas in treated patients, FR correlated with posttreatment inhibin B levels. The pregnancy rate in the entire treated group was 30.4%. No pregnancies were recorded in the control group.

Conclusion(s)

Recombinant human FSH may be a valuable pretreatment for oligozoospermic patients undergoing ICSI and may influence testicular paracrine activity.

Keywords:  Recombinant human FSH treatment, oligoasthenospermia, inhibin B, spermatogenesis, testicular paracrine activity