Colacurci Nicola, Monti Maria Gaia, Fornaro Felice, Izzo Gaia, Izzo Pierluigi, Trotta Carlo, Mele Daniela, De Franciscis Pasquale
Department of Obstetrics and Gynecology-Second University of Naples, Via Tasso 133, 80127 Naples, Italy.
J Androl. 2012 Jul-Aug;33(4):588-93. doi: 10.2164/jandrol.111.013326. Epub 2011 Aug 25.
A prospective randomized controlled study was designed to evaluate the effects of recombinant human follicle-stimulating hormone (rFSH) treatment on sperm DNA fragmentation in men with idiopathic oligoasthenoteratozoospermia (iOAT). One hundred twenty-nine men with sperm count less than 10 × 10(6) spermatozoa/mL and forward motility <25% were included; normal serum levels of FSH, luteinizing hormone (LH), and testosterone, and no other causes of infertility were enrolled. The patients were randomized into 2 groups: 65 men were treated on alternate days for 90 days with injections of 150 IU rFSH, and 64 subjects received nonantioxidant vitamin supplements. Main outcome measures were serum levels of FSH, LH, testosterone, and inhibin B and DNA fragmentation index (DFI) at baseline and after 90 days. No significant differences were observed between the 2 groups with regard to sperm parameters and hormone values. The DFI was similar between the 2 groups at the time of the enrollment but reduced significantly (P < .05) after rFSH therapy in study group, whereas no significant variation occurred in the control group. In the subgroup of patients with high basal DFI values (>15%), rFSH treatment significantly increased DFI (P < .01), whereas no significant variation occurred after 90 days of vitamin supplements. We conclude that rFSH administration improves sperm DNA integrity in iOAT men with increased DFI values. The degree of sperm DFI might be useful to identify those iOAT patients in which rFSH treatment can be advantageous.
一项前瞻性随机对照研究旨在评估重组人促卵泡激素（rFSH）治疗对特发性少弱畸精子症（iOAT）男性精子DNA碎片化的影响。纳入了129名精子浓度低于10×10⁶/mL且前向运动率<25%的男性；这些男性促卵泡激素（FSH）、黄体生成素（LH）和睾酮的血清水平正常，且不存在其他不孕原因。患者被随机分为两组：65名男性每隔一天注射150 IU rFSH，共治疗90天；64名受试者接受非抗氧化维生素补充剂。主要观察指标为基线时和90天后FSH、LH、睾酮、抑制素B的血清水平以及DNA碎片化指数（DFI）。两组在精子参数和激素值方面未观察到显著差异。两组在入组时DFI相似，但研究组在rFSH治疗后DFI显著降低（P<.05），而对照组无显著变化。在基础DFI值较高（>15%）的患者亚组中，rFSH治疗使DFI显著升高（P<.01），而维生素补充剂治疗90天后无显著变化。我们得出结论，给予rFSH可改善DFI值升高的iOAT男性的精子DNA完整性。精子DFI程度可能有助于识别那些rFSH治疗可能有益的iOAT患者。
