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.
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.