Efficacy Of UFSH In The Treatment Of Severe Oligozoospermia And Azoospermia

Objective:To observe the efficacy of uFSH in the treatment of idiopathic severe oligozoospermia and azoospermia.Methods:Using a single-centered and self-controlled clinical trial,we treated 65patients with idiopathic severe oligozoospermia and azoospermia with uFSH 75 IU/3d i.m.for 3 months,and evaluated the the semen parameters including sperm concentration,total sperm count and the percentage of motile sperm at 3 months.Results:According to whether the FSH before uFSH treatment is lower than 18 IU/L,65 patients were divided into oligozoospermia FSH<18IU/L group(23),oligozoospermia FSH?18IU/L group(3),azoospermia FSH<18 IU/L group(18),azoospermia FSH?18 IU/L group(21).In the oligozoospermia FSH<18IU/L group,13patients(56.52%)had an increase in the total sperm count.The average sperm concentration increased to(5.13±5.81)×10~6/mL after 3 months of treatment,[pre-treatment(2.30±2.28)×10~6/mL],compared with pre-treatment,the difference was statistically significant(P<0.05);the total sperm count also showed a significant upward trend after 3 months of treatment,rising from(9.18±10.03)×10~6 to(19.98±28.90)×10~6,the difference was statistically significant(P<0.05);sperm motility was not significantly different before and after treatment.In the azoospermia FSH<18IU/L group,3 cases(16.67%)found sperm in semen examination after treatment,and the sperm concentration increased to 30×10~6/mL,0.1×10~6/mL,1.2×10~6/mL.However,sperm concentration,total sperm number,and sperm motility were not statistically significant before and after treatment.In the azoospermia FSH?18 IU/L group,1 case(1/21)found sperm in semen after 3 months of treatment,and the sperm concentration was 0.5×10~6/mL,which was not statistically significant.In the group of oligozoospermia FSH?18IU/L,there was no significant improvement in semen quality after 3 months of treatment,including sperm concentration,total number and motility before and after treatment.During the follow-up,21 patients underwent testicular biopsy.The pathology was as follows:oligozoospermia FSH<18IU/L group 1 case(1/23)showed sperm maturation disorder.Azoospermia with FSH<18 IU/L group,8patients had low spermatogenesis,and 2 patient considered testicular maturation arrest.In the azoospermia FSH?18IU/L group,7 cases showed sertoli cell only syndrome,3cases showed testicular maturation arrest,and 1 case considered low spermatogenesis.Conclusion:uFSH can evidently improve the seminal quality of patients with idiopathic severe oligozoospermia and FSH below 18 IU/L,promote spermatogenesis in some patients with idiopathic azoospermia and FSH below 18 IU/L.For patients with idiopathic severe oligospermia and azoospermia with FSH higher than 18 IU/L,it is recommended to underwent the testicular histopathological examination and related gene detection,monitor the HBA level and other indicators during FSH treatment.Its short-term efficacy is still unclear and needs further study.