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

Background: In cases of azoospermia due to impaired spermatogenesis, spermatozoa can be retrieved by sperm extraction (TESE) from testicular biopsy. Objective: To evaluate the efficacy of pure follicle-stimulating hormone (pFSH) on sperm recovery, and measure the predictive value of testicular histology. Study design: 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. Results: 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). Conclusion: pFSH treatment improves the success of TESE for non-obstructive azoospermic men with normal FSH levels. (C) 2002 Elsevier Science Ireland Ltd. All rights reserved.