Combined hMG/hCG treatment in subfertile men with idiopathic normogonadotrophic oligozoospermia

Forty-eight patients with idiopathic normogonadotrophic oligozoospermia were treated with hMG plus hCG over a period of 3 months. Total sperm output increased by an average of 15.3 million spermatozoa per ejaculate and a similar significant increase was seen in the percentage of motile spermatozoa. Sixteen of the 48 men increased their sperm output by 25 million or more. Follow-up information was available in 33 patients. Ten pregnancies were reported within one year after initiation of treatment. Six of 12 responders impregnated their wives, whereas only 4 pregnancies were reported in a group of 21 non-responders. Endocrinological investigations showed no differences in mean basal levels of LH and FSH, or in the gonadotrophin response to a 100 micrograms GnRH stimulation between responders and non-responders. However, mean basal plasma testosterone concentration was significantly lower in the responder group than in the non-responders. Responsiveness to gonadotrophin treatment tended to be better in patients with basal plasma testosterone concentration lower than 4.5 ng/ml. Combined hMG/hCG treatment in subfertile men with idiopathic oligozoospermia seems to be efficient in only a small proportion of cases.