Serum bioactive follicle-stimulating hormone in men with idiopathic azoospermia and oligospermia.

Using an in vitro granulosa cell aromatase bioassay (GAB), serum bioactive FSH (bio-FSH) levels were measured in 20 fertile men and 74 men with idiopathic azoospermia or oligospermia. The serum bio-FSH levels measured by the GAB assay and the immunoreactive FSH (immuno-FSH) levels measured by RIA were positively correlated (r = 0.93). Compared to normal men, serum bio-FSH and immuno-FSH levels were elevated in patients with idiopathic azoospermia associated with severe germinal epithelium damage; the bioactive to immunoreactive ratio (B:I ratio) of FSH in these men [mean, 1.5 +/- 0.5 (+/- SD)] was significantly lower than that in fertile men (2.7 +/- 0.8). Similarly, in men with moderate and severe oligospermia, the B:I ratios of FSH were decreased (1.4 +/- 0.4 and 1.7 +/- 0.3, respectively). Although serum immuno-FSH levels correlated weakly with mean sperm concentrations in the normal and oligospermic men (r = -0.35), no relationship was found between serum bio-FSH and sperm concentrations. The B:I ratio of FSH correlated weakly with sperm concentration (r = 0.46). These findings suggest that the B:I ratio of FSH measured by the GAB assay decreases in patients with low sperm concentrations and germinal cell failure.