Follicle-stimulating hormone treatment for men with idiopathic oligoteratoasthenozoospermia before in vitro fertilization: the impact on sperm microstructure and fertilization potential

Objective: To assess the effect of FSH on sperm fertilization potential and sperm intracellular structure in men with oligoteratoasthenozoospermia and a proven low fertilization rate in IVF. Design: Prospective, randomized, partial crossover study. Setting: IVF Unit, Colds Campus, Rabin Medical Center, Petah Tikva, Israel. Patient(s): Forty normogonadotropic, normogonadal men with oligoteratoasthe nozoospermia and at least one previous IVF attempt in which fertilization f ailed or the fertilization rate was <30%. Intervention(s): The men were randomly assigned to treatment with daily inj ections of 75 IU of FSH or 150 IU of FSH for at least 60 days before IVF tr eatment. A control group of men underwent an IVF cycle without treatment an d then were randomly assigned to join group 1A or 1B for an additional IVF cycle with treatment. Main Outcome Measure(s): LH, FSH, and testosterone levels during FSH treatm ent, evaluation of ultra-morphologic changes in sperm by electron microscop y, and comparison of fertilization rates in the control and study groups. Result(s): After treatment with 75 IU or 150 IU of FSH, the mean fertilizat ion rates were 19.7% and 20.5%, respectively, compared with a 5.8% fertiliz ation rate in the study control cycles. Conclusion(s): Prolonged treatment with FSH results in a significant increa se in fertilization rates. This effect revised and accepted maybe related t o improvements in subcellular components of the sperm. (C) 1999 by American Society for Reproductive Medicine.