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FSH treatment improves sperm function in patients after varicocelectomy

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Abstract

One-hundred and eighty-three patients affected with idiopathic left varicocele, aged between 18 and 45 years, surgically treated have been studied. They were divided in 3 subsets according to sperm count: group A: <10 × 106/ml, group B: 10−20 ×106/ml, group C: >20 × 106/ml. Six months after surgery 115 patients were treated for 3 months with pure human FSH: 75 IU im every other day, while 68 patients treated with placebo served as control group. After therapy, group A showed a significant clear-cut improvement of sperm parameters: count, forward progression, swollen tails and cervical mucus penetration test (CMPT). In group B a significant improvement of sperm motility, viability, DNA integrity and CMPT was observed, while in group C only a significant improvement of CMPT was observed. In conclusion, it can be suggested that FSH treatment in patients after varicocelectomy could improve spermatogenesis, particularly in those who previously have more compromised sperm quality. On the contrary, no significant difference of sperm patterns was recorded in the control group before and after placebo.

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References

  1. Pryor J.L., Howards S.S. Varicocele. Urol. Clin. North Am. 1987, 14: 499–513.

    CAS  PubMed  Google Scholar 

  2. Zarrilli L., Fabbrini A., Abate S., Foresta C. Il Varicocele. Fisiopatologia, Diagnosi, Trattamento. Idelson, Napoli, 1983.

    Google Scholar 

  3. Nieschlag E. Care for the infertile male. Clin. Endocrinol. (Oxf) 1993, 38: 123–133.

    Article  CAS  Google Scholar 

  4. Hudson R.W. The endocrinology of varicoceles. Fertil. Steril. 1988, 49: 199–208.

    CAS  PubMed  Google Scholar 

  5. Osegbe D.N. Pulse pattern of Luteinizing Hormone (LH) in patients with varicocele: a preliminary report. Andrologia 1989, 21: 23–27.

    Article  CAS  PubMed  Google Scholar 

  6. Adamopoulos D., Lawrence D.M., Vassilopoulos P., Kapolla N., Kontogeorgos L., Mcgarrigle H.H.G. Hormone levels in the reproductive system of normospermic men and patients with oligospermia and varicocele. J. Clin. Endocrinol. Metab. 1984, 59: 447–452.

    Article  CAS  PubMed  Google Scholar 

  7. Nagao R.R., Plymate S.R., Berger R.E., Perin E.B., Paulsen C.A. Comparison of gonadal function between fertile and infertile men with varicoceles. Fertil. Steril. 1986, 46: 930–933.

    CAS  PubMed  Google Scholar 

  8. Conte D., Latino C., Di Luigi L., Dondero F., Giovenco P., Isidori A. Possibile ruolo delle prostaglandine nella dispermia da varicocele. J. Endocrinol. Invest. 1981, 4 (Suppl. 2): 49.

    Google Scholar 

  9. Baccetti B., Collodel G. and Piomboni P. Apoptosis in human ejaculated sperm cells (Notulae Seminologicae 9). J. Submicrosc. Cytol. Pathol. 1996, 28: 587–596.

    CAS  PubMed  Google Scholar 

  10. Baccetti B., Strehler E., Capitani S., Collodel G., De Santo M., Moretti E., Piomboni P., Wiedeman R., Sterzik K. The effect of follicle stimulating hormone therapy on human sperm structure (Notulae Seminologicae 11). Human Reprod. 1997, 12: 1955–1968.

    Article  CAS  Google Scholar 

  11. Acosta A., Oehninger S., Ertunc H., Philput C. Possible role of pure human follicle-stimulating hormone in the treatment of severe male factor infertility by assisted reproduction: Preliminary report. Fertil. Steril. 1991, 55: 1150–1156.

    CAS  PubMed  Google Scholar 

  12. Foresta C., Bettella A., Ferlin A., Garolla A., Rossato M. Evidence for a stimulatory role of FSH on spermatogonial population in adult men. Fertil. Steril. 1998, 69: 636–642.

    Article  CAS  PubMed  Google Scholar 

  13. Zarrilli S., Paesano L., Mirone V., Finelli L., De Rosa M. Valutazione dei parametri seminologici ed ormonologici nel varicocele idiopatico prima e dopo intervento chirurgico. Chir. Ital. 1998, 50: 21–28.

    CAS  PubMed  Google Scholar 

  14. World Health Organization. WHO laboratory manual for the examination of human semen and sperm-cervical mucus interaction, ed. 3. Cambridge University Press, Cambridge, U.K., 1992.

    Google Scholar 

  15. De Rosa M., Amalfi B., Mennitti M., Zarrilli S., Lombardi G. The usefulness of new tests in the evaluation of the ejaculate. In: Colpi G., Pozza D. (Eds.), Diagnosing male infertility. New possibilities and limits. Karger, Basel, 1992, pp. 19–26.

    Google Scholar 

  16. Giordano-Lanza G., Montagnani S., Palma C., De Rosa M., Vita A., Lombardi G. Use of acridine orange for morphological study on male infertility. In: Spera G., De Kretser D.M. (Eds.), Morphological basis of human reproductive function. Plenum Press, New York-London, 1987, pp. 251–255.

    Chapter  Google Scholar 

  17. Lombardi G., De Rosa M., Quagliozzi L., Aurigemma A.C., Panza N. Daily and alternate day treatment with an LH-RH analogue in the therapy of idiopathic hypogonadotropic hypogonadism. J. Androl. 1984, 5: 111–117.

    Google Scholar 

  18. Carreras A., Palma A., Mendoza C. Hypoosmotic swelling test in normo- oligo- asthenoand oligoasthenozoospermic men before and after swim-up separation of spermatozoa. Andrologia 1990, 22: 313–317.

    Article  CAS  PubMed  Google Scholar 

  19. Shutte B. Penetration ability of human spermatozoa into standardized bovine cervical mucus (Penetrak) in patients with normal and pathological semen samples. Andrologia 1987, 19: 217–223.

    Article  Google Scholar 

  20. Baccetti B., Burrini A.G., Capitani S., Costantino-Ceccarini E., Collodel G., Di Cairano G., Estenoz M., Martini L., Moretti E., Piomboni P. Studies on varicocele. II. The inhibin secretion. J. Submicrosc. Cytol. Pathol. 1993, 25: 137–144.

    CAS  PubMed  Google Scholar 

  21. Isidori A. A modern approach to the gonadotropin treatment in oligozoospermia. Andrologia 1981, 13: 187–197.

    Article  CAS  PubMed  Google Scholar 

  22. Francis G.L., Brown T.J., Bercu B.B. Regulation by homologous hormones exposure. Biol. Reprod. 1981, 24: 961–965.

    Article  Google Scholar 

  23. Crottaz B., Senn A., Reymond M., Rey F., Germond M., Gomez F. Follicle-stimulating hormone bioactivity in idiopathic normogonadotropic oligoasthenozoospermia: doubleblind trial with gonadotropin-releasing hormone. Fertil. Steril. 1992, 57: 1034–1043.

    CAS  PubMed  Google Scholar 

  24. Vihko K.K., Lapolt P.S., Mishimor K., Hsueh A.J.W. Stimulatory effects of recombinant FSH on Leydig cell function and spermatogenesis in immature hypophysectomized rats. Endocrinology 1991, 129: 1926–1932.

    Article  CAS  PubMed  Google Scholar 

  25. World Health Organization The influence of varicocele on parameters of fertility in a large group of men presenting to infertility clinics. Fertil. Steril. 1992, 57: 1289–1293.

    Google Scholar 

  26. Nieschlag E., Hertle L., Fischedick A., Behre H.M. Treatment of Varicocele: Counselling as effective as occlusion of the vena spermatica. Hum. Reprod. 1995, 10: 347–353.

    CAS  PubMed  Google Scholar 

  27. Nieschlag E., Hertle L., Fischedick A., Abshagen K., Behre H.M. Update on treatment of Varicocele: Counselling as effective as occlusion of the vena spermatica. Hum. Reprod. 1998, 13: 2147–2150.

    Article  CAS  PubMed  Google Scholar 

  28. Schlegel P.N. Is assisted reproduction the optimal treatment for varicocele-associated male infertility? A cost effectiveness analysis. Urology 1997, 49: 83–90.

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Dipartimento di Endocrinologia ed Oncologia Molecolare e Clinica, Via Belsito 19, 80123, Napoli, Italy

    S. Zarrilli, L. Paesano, A. Colao, G. Lombardi &  Michele De Rosa

  2. Dipartimento di Urologia e Nefrologia, University of Napoli “Federico II”, Italy

    V. Mirone

Authors
  1. S. Zarrilli
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  2. L. Paesano
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  3. A. Colao
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  4. V. Mirone
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  5. G. Lombardi
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  6. Michele De Rosa
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Correspondence to Michele De Rosa.

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Zarrilli, S., Paesano, L., Colao, A. et al. FSH treatment improves sperm function in patients after varicocelectomy. J Endocrinol Invest 23, 68–73 (2000). https://doi.org/10.1007/BF03343681

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  • DOI: https://doi.org/10.1007/BF03343681

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