The effect of pure FSH administration in non-obstructive azoospermic men on testicular sperm retrieval

In cases of azoospermia due to impaired spermatogenesis, spermatozoa can be retrieved by sperm extraction (TESE) from testicular biopsy.

To evaluate the efficacy of pure follicle-stimulating hormone (pFSH) on sperm recovery, and measure the predictive value of testicular histology.

In all, 108 patients were studied. These included those with Sertoli cell-only (n=16), focal spermatogenesis (n=36), maturation arrest (n=19) and hypospermatogenesis (n=37) in previous explorative biopsies. All had normal serum FSH, LH and testosterone levels. In 63 cases, 75IU pFSH were administered, either i.m. or s.c., three times a week, for 3 months and the control group (n=45) no treatment was given.

The sperm retrieval rate was 64% (40/63 pts.) in pFSH treated men versus 33% (15/45 pts.) in controls (P<0.01). In Sertoli cell-only patients, the rate was 2/7 (28%) versus 4/9 (44%) in controls and treated men, respectively (P>0.05); and 3/8 (37%) versus 5/11 (45%) in maturation arrest (P>0.05); 6/14 (42%) versus 18/23 (78%) in hypospermatogenesis (P<0.05); and 4/16 (25%) versus 13/20 (65%) in focal spermatogenesis (P<0.01). Treatment with pFSH also improved the quantity of retrieved spermatozoa compared to control values (P<0.05).

pFSH treatment improves the success of TESE for non-obstructive azoospermic men with normal FSH levels.