Recombinant human follicle-stimulating hormone as a pretreatment for idiopathic oligoasthenoteratozoospermic patients undergoing intracytoplasmic sperm injection

Objective: To evaluate the efficacy of recombinant human FSH pretreatment in improving fertilization and pregnancy rates in oligozoospermic patients who are undergoing ICSI. Design: Prospective, controlled, clinical study. Setting: A research institute's reproductive unit. Patient(s): Thirty-three subjects with idiopathic oligoasthenoteratozoospermia who failed to conceive after previous ICSI attempts. Intervention(s): Treatment with recombinant human FSH 150 IU for 3 months (23 patients) or no treatment (10 patients); clinical, hormonal, and seminal evaluation before and after treatment. Main Outcome Measure(s): Testicular volume, sperm parameters, FSH, LH, T, E-2, and inhibin B plasma levels, E/T ratio, and fertilization and pregnancy rates. Result(s): Treatment with 150 IU of FSH induced a significant increase in testicular volume and sperm parameters. The mean fertilization rate (FR) after ICSI cycles was higher, although not significantly, in treated patients when compared with controls (62.3 +/- 22.4 vs. 47.2 +/- 20.4). A strong negative correlation was observed between FR and serum FSH, inhibin B and E/T ratio in controls, whereas in treated patients, FR correlated with posttreatment inhibin B levels. The pregnancy rate in the entire treated group was 30.4%. No pregnancies were recorded in the control group. Conclusion(s): Recombinant human FSH may be a valuable pretreatment for oligozoospermic patients undergoing ICSI and may influence testicular paracrine activity. (C) 2003 by American Society for Reproductive Medicine.