Foresta C, Bettella A, Ferlin A, Garolla A, Rossato M
Clinica Medica 3, University of Padova, Italy.
Fertil Steril. 1998 Apr;69(4):636-42. doi: 10.1016/s0015-0282(98)00008-9.
To evaluate the effects of treatment with FSH on seminal indices and on the seminiferous epithelium of oligozoospermic subjects with normal FSH plasma levels.
Placebo-controlled, double-blind randomized study.
Academic setting.
PATIENT(S): Ninety subjects with idiopathic oligozoospermia (sperm count of < 10 x 10(6)/mL) and normal plasma levels of FSH.
INTERVENTION(S): Three months of treatment with FSH (60 patients) or placebo (30 patients); bilateral testicular fine-needle aspiration.
MAIN OUTCOME MEASURE(S): Seminal indices; testicular cytologic features; plasma levels of FSH, LH, and testosterone; and ultrasonographic testicular examination.
RESULT(S): According to seminal indices, patients treated with FSH and placebo were classified as nonresponders or as responders (as determined by at least a doubling of sperm count). No placebo-treated patients responded to treatment. Among FSH-treated patients, 20 responded to hormonal treatment and 40 did not. The results of pretreatment cytologic examination of testicular specimens from patients who did not respond to FSH treatment were consistent with hypospermatogenesis associated with maturational disturbances at the spermatid level. In contrast, patients who responded to treatment with FSH had isolated hypospermatogenesis without maturational disturbances. After FSH therapy, we detected an increase of spermatogonia and spermatocyte population in both the responder and nonresponder subjects. This increase was associated with an activation of spermatogenic and spermiogenic processes and with a rise in ejaculated sperm concentration only when isolated hypospermatogenesis was present (responder patients).
CONCLUSION(S): The findings of this study demonstrate that FSH treatment increases the spermatogonial population in men. This treatment may be appropriate for oligozoospermic subjects who have normal FSH plasma levels and a testicular evaluation characterized by hypospermatogenesis without maturational disturbances.
评估促卵泡激素（FSH）治疗对血浆FSH水平正常的少精子症患者精液指标及生精上皮的影响。
安慰剂对照、双盲随机研究。
学术机构。
90例特发性少精子症患者（精子计数<10×10⁶/mL）且血浆FSH水平正常。
FSH治疗3个月（60例患者）或安慰剂治疗（30例患者）；双侧睾丸细针穿刺抽吸。
精液指标；睾丸细胞学特征；FSH、黄体生成素（LH）和睾酮的血浆水平；以及睾丸超声检查。
根据精液指标，接受FSH和安慰剂治疗的患者被分类为无反应者或反应者（通过精子计数至少翻倍确定）。没有接受安慰剂治疗的患者对治疗有反应。在接受FSH治疗的患者中，20例对激素治疗有反应，40例无反应。对FSH治疗无反应的患者睾丸标本预处理细胞学检查结果与精子生成减少相关，伴有精子细胞水平的成熟障碍。相比之下，对FSH治疗有反应的患者存在孤立的精子生成减少但无成熟障碍。FSH治疗后，我们在反应者和无反应者中均检测到精原细胞和精母细胞数量增加。仅当存在孤立的精子生成减少时（反应者患者），这种增加与生精和精子形成过程的激活以及射精精子浓度的升高相关。
本研究结果表明，FSH治疗可增加男性精原细胞数量。这种治疗可能适用于血浆FSH水平正常且睾丸评估显示为无成熟障碍的精子生成减少的少精子症患者。
