Treatment of the male with follicle-stimulating hormone in intrauterine insemination with husband's spermatozoa: a randomized study

Matorras, Roberto; Pérez, Claudio F.; Corcóstegui, Beatriz; Pijoán, J I; Ramón, Olga; Delgado, P.; Rodriguez-Escudero, F.J.

doi:10.1093/humrep/12.1.24

Cited by 51 publications

(5 citation statements)

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“…A recent systematic review, including six randomized controlled trials with 456 participants, showed a beneficial effect of gonadotropin treatment in men with idiopathic infertility on live birth and pregnancy rate [ 13 ]. Five trials reported spontaneous pregnancies after gonadotropin treatment but only one trial reported live birth rates [ 10 , 13 , 14 , 15 , 16 , 17 ]. The reviewers concluded that gonadotropin treatment resulted in a statistically significant increase in live births and pregnancies [ 8 ].…”

Section: Empirical Treatmentmentioning

confidence: 99%

“…The reviewers concluded that gonadotropin treatment resulted in a statistically significant increase in live births and pregnancies [ 8 ]. However, there was no significant improvement in pregnancy rate after IUI and ICSI cycles within the gonadotropin treatment period [ 17 , 18 ]. In conclusion, further research is warranted, possibly in combination with artificial reproductive technologies, because of the small number of trials and participants.…”

Section: Empirical Treatmentmentioning

confidence: 99%

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Empirical medical therapy in idiopathic male infertility: Promise or panacea?

Jung

Seo

2014

Clin Exp Reprod Med

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Male factors account for 20%-50% of cases of infertility and in 25% of cases, the etiology of male infertility is unknown. Effective treatments are well-established for hypogonadotropic hypogonadism, male accessory gland infection, retrograde ejaculation, and positive antisperm antibody. However, the appropriate treatment for idiopathic male infertility is unclear. Empirical medical treatment (EMT) has been used in men with idiopathic infertility and can be divided into two categories based on the mode of action: hormonal treatment and antioxidant supplementation. Hormonal medications consist of gonadotropins, androgens, estrogen receptor blockers, and aromatase inhibitors. Antioxidants such as vitamins, zinc, and carnitines have also been widely used to reduce oxidative stress-induced spermatozoa damage. Although scientifically acceptable evidence of EMT is limited because of the lack of large, randomized, controlled studies, recent systematic reviews with meta-analyses have shown that the administration of gonadotropins, anti-estrogens, and oral antioxidants results in a significant increase in the live birth rate compared with control treatments. Therefore, all physicians who treat infertility should bear in mind that EMT can improve semen parameters and subsequent fertility potential through natural intercourse.

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Section: Empirical Treatmentmentioning

confidence: 99%

Section: Empirical Treatmentmentioning

confidence: 99%

Empirical medical therapy in idiopathic male infertility: Promise or panacea?

Jung

Seo

2014

Clin Exp Reprod Med

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“…Unfortunately, FSH therapy is relatively costly and involves repeated injections which may reflect on patient preference and compliance. Several other researchers [4,5] tried to treat male infertility with FSH in unselected patients, however none reported increased pregnancy rates. Therefore, FSH therapy cannot be recommended in unselected men.…”

Section: Gonadotropin Therapymentioning

confidence: 99%

An Evidence-Based Perspective to the Medical Treatment of Male Infertility: A Short Review

Ghanem

Shamloul

2009

Urol Int

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Introduction: Evidence-based medicine (EBM) is the integration of best research evidence with clinical expertise and patient preferences and values. Aim: This narrative review aims to assist the physicians to make informed decisions based on the best available evidence in the area of male infertility and the patients’ own preferences and values. Methods: In this review we present the current state of knowledge and uncertainties about the medical management of male infertility. We describe the best available evidence from systematic reviews, randomized controlled studies and observational studies where appropriate. Results: Data from the literature suggest that gonadotropin treatment of male infertility can lead to a significant increase in pregnancy rates, however larger studies are needed to confirm such findings. Studies including combinations of antiestrogens, antioxidants and androgens are promising but need confirmation with further research. Conclusions: Most current combination therapies consist of orphan medications without industry support. Andrology research centers and other dedicated departments and units need to conduct randomized controlled trials of sufficient duration, sample number and robust design for groups most likely to benefit from antiestrogens, L-carnitine, antioxidants, and combination therapy. The ease of administration, low cost and mild side effects of antiestrogens justify their utility despite insufficient evidence of effect as monotherapies. Randomized controlled trials assessing other forms of medical therapy and combination therapy are available but are still in the preliminary stages.

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“…Many authors have not found a significant increase in sperm parameters after FSH administration [ 1 , 2 , 21 , 22 ]. Nevertheless, there is evidence to support FSH treatment in idiopathic infertile patients with oligozoospermia and serum FSH concentration within the normal range, as a valid strategy to improve sperm quality [ 4 ].…”

Section: Discussionmentioning

confidence: 99%

Follicle-Stimulating Hormone Treatment and Male Idiopathic Infertility: Effects on Sperm Parameters and Oxidative Stress Indices according to FSHR c. 2039 A/G and c. -29 G/A Genotypes

Mongioì

Condorelli

Alamo

et al. 2020

JCM

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Scientific evidence shows that the administration of follicle-stimulating hormone (FSH) to infertile patients with normal serum FSH concentrations improves sperm parameters in oligozoospermic men. The aim of this study was to evaluate the effects of highly purified urofollitropin (hpFSH) on conventional and bio-functional sperm parameters and on oxidative stress indices in patients with idiopathic infertility. We also evaluated the response to hpFSH on these parameters in relationship to FSHR c. 2039 A/G and FSHR c. -29 G/A genotypes. A prospective longitudinal study was conducted on 42 patients with idiopathic male infertility, 23 of whom underwent to FSHR c. 2039 A/G and FSHR c. -29 G/A genotyping. Each patient was asked to collect two semen samples before and after administration of 150 IU hpFSH three times a week for 16 weeks. Patients were divided into responders or non-responders based on whether their total sperm count had at least doubled or was less than double at the end of treatment, respectively. Responders showed a significantly higher semen volume, sperm concentration, spermatids, and leukocytes. Non-responders had a significant decrease of the percentage of spermatozoa in early apoptosis after hpFSH administration. Oxidative stress indexes did not differ significantly after FSH administration in both groups. Conventional and bio-functional sperm parameters did not differ in patients with FSHR c. 2039 GG and AA genotypes, and FSHR c. -29 GG genotype both before and after FSH administration. The FSHR c. 2039 and FSHR -29 G/A genotypes and allelic distribution did not differ between responders and non-responders. FSH showed to be capable of ameliorating sperm parameters in about half patients treated, therefore it may be helpful in patients with idiopathic infertility.

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Treatment of the male with follicle-stimulating hormone in intrauterine insemination with husband's spermatozoa: a randomized study

Cited by 51 publications

References 0 publications

Empirical medical therapy in idiopathic male infertility: Promise or panacea?

Empirical medical therapy in idiopathic male infertility: Promise or panacea?

An Evidence-Based Perspective to the Medical Treatment of Male Infertility: A Short Review

Follicle-Stimulating Hormone Treatment and Male Idiopathic Infertility: Effects on Sperm Parameters and Oxidative Stress Indices according to FSHR c. 2039 A/G and c. -29 G/A Genotypes

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