A Systematic Review Of Human Follicle Stimulating Hormone For Treatment Of Idiopathic Oligozoospermia

Objective:At present, follicle stimulating hormone for treatment of idiopathicoligozoospermia is still existing some controversy, this article was to find outwhether the treatment of follicle stimulating hormone might improve pregnancy ratesand semen quality in patients. It can provide the evidence for the clinical treatment.Methods:Retrieving the evaluation of Randomized trial which concerning human folliclestimulating hormone for treatment of idiopathic oligozoospermia from the followingdatabases: EMBASE (1980.1-2012.11), OVID (1950.1-2012.11), Pub-med/Medlinedatabase (1950.1-2012.11), Cochrane Centre database/Chinese Evidence-BasedMedicine (the CCD\the CEBM), the Cochrane library, CBM(1987.1-2012.11）China Academic Journal (CNKI:1994.1-2012.11), VIP(1989.1-2012.11). Collect allthe relevant literature. Preliminary screening of all included studies, obtain the fulltext of the screened literature, to evaluate the test by the Risk of bias assessment toolwhich recommended by the Cochrane Collaboration and use RevMan5.1software forMeta-analysis. The outcome measure was spontaneous pregnancy rates, fertilizationand pregnancy rates after assisted reproductive technology, ejaculate volume,spermmorphology, sperm concentration,sperm motility， spermatogonia andspermatocytes, subcellular components of the sperm.ResultWe find eight randomized controlled trials met our criteria,a totalof444patients in the trials,the results of Systematic review indicates: evaluationindexes of pregnancy include spontaneous pregnancy rates, fertilization and clinicalpregnancy rates after assisted reproductive technology.comparing the rate of oocytes tetrieved in two groups, total WMD=14.84,95%CI=（5.58,24.10）, Z=3.14，P=0.002two groups have significant differences in statistics.compared spontaneous pregnancyrates, RR=2.63,95%CI=（0.80，8.65），Z=1.59，P=0.11,there is no difference in twogroups.compared clinical pregnancy rate, OR=2.33,95%CI（1.17,4.65），Z=2.40，P=0.02.There is significant difference in two groups.evaluation indictors of semenparameters by light microscopy after treatment of follicle-stimulating hormone,including ejaculate volume,sperm concentration,sperm morphology, sperm motility.comparing ejaculate volume after treatment of follicle-stimulating hormone andplacebo: WMD(Total)=0.03,95%CI=（-0.53,0.60）。Z=0.11，P=0.91,two groups haveno significant difference in statistics.compared sperm concentration in the groups,WMD(Total)=3.14，95%CI=（1.47，4.82），Z=3.68，P=0.0002, two groups have nosignificant differences in statistics. compared sperm morphology in the groups,WMD (Total)=0.52，95%CI=（-2.00,3.04），Z=0.40，P=0.69, two groups have nosignificant difference in statistics. compared sperm motility in the treated andcontrolled groups, WMD (Total)=2.64，95%CI=（-6.14,11.43），Z=0.59，P=0.56,thereis no significant difference in statistics. semen quality by electron microscopy includespermatogonia and spermatocytes, subcellular components of the sperm.the effectafter treatment of follicle-stimulating hormone, may be related to improve subcellularcomponents of the sperm, increase the spermatogonial population and spermproductionConclusionSystematic review indicates that human follicle stimulating hormone for treatmentof idiopathic oligozoospermia fails to improve the patients，semen quality by light microscopy and spontaneous pregnancy rates, but it canincrease pregnancy rates after assisted reproductive technology and semen quality byelectron microscopy.