Reduced Seminal Concentration of CD45pos Cells after Follicle-Stimulating Hormone Treatment in Selected Patients with Idiopathic Oligoasthenoteratozoospermia

The present study evaluated the conventional sperm parameters and the seminal concentration of CD45pos cells (pan-leukocyte marker) of infertile patients with idiopathic oligoasthenoteratozoospermia (OAT). The patients were arbitrarily divided into three groups treated with recombinant follicle-stimulating hormone FSH: α (Group A = 20 patients), recombinant FSH-β (Group B = 20 patients), and highly purified human FSH (Group C = 14 patients). All treated groups achieved a similar improvement of the main sperm parameters (density, progressive motility, and morphology), but only the increase in the percentage of spermatozoa with normal morphology was significant compared to the baseline in all three examined groups. Moreover, all groups had a significant reduction of the seminal concentration of CD45pos cells and of the percentage of immature germ cells. Before and after the treatment, the concentration of CD45pos cells showed a positive linear correlation with the percentage of immature germ cells and a negative correlation with the percentage of spermatozoa with regular morphology. These results demonstrate that treatment with FSH is effective in patients with idiopathic OAT and that there are no significant differences between the different preparations. The novelty of this study is in the significant reduction of the concentration of CD45pos cells observed after the treatment.

[1]  E. Vicari,et al.  Follicle-stimulating hormone treatment in normogonadotropic infertile men , 2013, Nature Reviews Urology.

[2]  W. Weidner,et al.  Reference Values for Testicular Volume, Epididymal Head Size and Peak Systolic Velocity of the Testicular Artery in Adult Males Measured by Ultrasonography , 2012, Ultraschall in der Medizin.

[3]  N. Colacurci,et al.  Recombinant human FSH reduces sperm DNA fragmentation in men with idiopathic oligoasthenoteratozoospermia. , 2012, Journal of andrology.

[4]  S. Seshadri,et al.  Detection of subpopulations of leucocytes in different subgroups of semen sample qualities , 2012, Andrologia.

[5]  E. Grober,et al.  The incidence and effect of bacteriospermia and elevated seminal leukocytes on semen parameters. , 2012, Fertility and sterility.

[6]  J. Wolf,et al.  Seminal leukocytes are Good Samaritans for spermatozoa. , 2011, Fertility and sterility.

[7]  F. Zullo,et al.  Effects of highly purified follicle-stimulating hormone on sperm DNA damage in men with male idiopathic subfertility: A pilot study , 2011, Journal of endocrinological investigation.

[8]  Organización Mundial de la Salud WHO laboratory manual for the examination and processing of human semen , 2010 .

[9]  A. Lenzi,et al.  Epidemiology, diagnosis, and treatment of male hypogonadotropic hypogonadism. , 2009, Journal of endocrinological investigation.

[10]  E. Akbay,et al.  The efficacy of recombinant human follicle-stimulating hormone in the treatment of various types of male-factor infertility at a single university hospital. , 2009, Journal of andrology.

[11]  S. Rajender,et al.  Hormonal treatment of male infertility: promises and pitfalls. , 2008, Journal of andrology.

[12]  Y. Ogawa,et al.  Relationship between testicular size by ultrasonography and testicular function: Measurement of testicular length, width, and depth in patients with infertility , 2008, International journal of urology : official journal of the Japanese Urological Association.

[13]  G. Bartsch,et al.  Assessment of the intratesticular resistive index by colour Doppler ultrasonography measurements as a predictor of spermatogenesis , 2008, BJU international.

[14]  R. Herwig,et al.  Correlation of leukocytospermia with clinical infection and the positive effect of antiinflammatory treatment on semen quality. , 2006, Fertility and sterility.

[15]  E. Porcu,et al.  Effects of high doses of recombinant human follicle-stimulating hormone in the treatment of male factor infertility: results of a pilot study. , 2006, Fertility and sterility.

[16]  G. Cavallini Male idiopathic oligoasthenoteratozoospermia. , 2006, Asian journal of andrology.

[17]  A. Isidori,et al.  Treatment of male infertility. , 2005, Contraception.

[18]  P. Piomboni,et al.  Effect of follicle-stimulating hormone on sperm quality and pregnancy rate. , 2004, Asian journal of andrology.

[19]  C. Niederberger,et al.  Recombinant human follicle-stimulating hormone as a pretreatment for idiopathic oligoasthenoteratozoospermic patients undergoing intracytoplasmic sperm injection. , 2003, Fertility and sterility.

[20]  M. Fernández-Arjona,et al.  Relationship between gonadotrophin secretion, inhibin B and spermatogenesis in oligozoospermic men treated with highly purified urinary follicle-stimulating hormone (uFSH-HP): a preliminary report. , 2003, European journal of obstetrics, gynecology, and reproductive biology.

[21]  A. Agarwal,et al.  Leukocytospermia is associated with increased reactive oxygen species production by human spermatozoa. , 2002, Fertility and sterility.

[22]  A. Agarwal,et al.  Increased DNA damage in sperm from leukocytospermic semen samples as determined by the sperm chromatin structure assay. , 2002, Fertility and sterility.

[23]  Kevin Barraclough,et al.  I and i , 2001, BMJ : British Medical Journal.

[24]  A. Agarwal,et al.  Relationship between seminal white blood cell counts and oxidative stress in men treated at an infertility clinic. , 2001, Journal of andrology.

[25]  A. Campana,et al.  Evaluation of 'round cells' in semen analysis: a comparative study. , 2000, Human reproduction update.

[26]  G. Arnaldi,et al.  Effects of long‐term treatment with human pure follicle‐stimulating hormone on semen parameters and sperm‐cell ultrastructure in idiopathic oligoteratoasthenozoospermia , 2000, Andrologia.

[27]  G. Ricci,et al.  Leukocyte detection in human semen using flow cytometry. , 2000, Human reproduction.

[28]  T. Irez,et al.  Does leukocytospermia associate with poor semen parameters and sperm functions in male infertility? The role of different seminal leukocyte concentrations. , 2000, European journal of obstetrics, gynecology, and reproductive biology.

[29]  M. Plebani,et al.  FSH in the treatment of oligozoospermia , 2000, Molecular and Cellular Endocrinology.

[30]  M. Kovo,et al.  Follicle-stimulating hormone treatment for men with idiopathic oligoteratoasthenozoospermia before in vitro fertilization: the impact on sperm microstructure and fertilization potential. , 2000, Fertility and sterility.

[31]  E. Nieschlag,et al.  Role of FSH in the regulation of spermatogenesis: clinical aspects , 1999, Clinical endocrinology.

[32]  E. Nieschlag,et al.  Role of FSH in male gonadal function. , 1999, Annales d'endocrinologie.

[33]  David Handelsman,et al.  Efficacy and safety of recombinant human follicle stimulating hormone (Gonal-F) with urinary human chorionic gonadotrophin for induction of spermatogenesis and fertility in gonadotrophin-deficient men. , 1999, Human reproduction.

[34]  Efficacy and safety of highly purified urinary follicle‐stimulating hormone with human chorionic gonadotropin for treating men with isolated hypogonadotropic hypogonadism , 1998 .

[35]  C. Foresta,et al.  Evidence for a stimulatory role of follicle-stimulating hormone on the spermatogonial population in adult males. , 1998, Fertility and sterility.

[36]  E. Nieschlag,et al.  Recombinant human follicle stimulating hormone for treatment of male idiopathic infertility: a randomized, double-blind, placebo-controlled, clinical trial. , 1998, Human reproduction.

[37]  J. Kratzsch,et al.  Effects of pure human follicle‐stimulating hormone (pFSH) on sperm quality correlate with the hypophyseal response to gonadotrophin‐releasing hormone (GnRH) * , 2009, Andrologia.

[38]  B. Corcóstegui,et al.  Treatment of the male with follicle-stimulating hormone in intrauterine insemination with husband's spermatozoa: a randomized study. , 1998, Human reproduction.

[39]  P. Piomboni,et al.  The effect of follicle stimulating hormone therapy on human sperm structure (Notulae seminologicae 11). , 1997, Human reproduction.

[40]  K. Aittomäki,et al.  Men homozygous for an inactivating mutation of the follicle-stimulating hormone (FSH) receptor gene present variable suppression of spermatogenesis and fertility , 1997, Nature Genetics.

[41]  L. Montano,et al.  [Value of high-dose pure FSH in the treatment of idiopathic male infertility]. , 1996, Journal d'urologie.

[42]  T. Plant,et al.  Follicle-stimulating hormone amplifies the population of differentiated spermatogonia in the hypophysectomized testosterone-replaced adult rhesus monkey (Macaca mulatta). , 1995, Endocrinology.

[43]  M. Seibel,et al.  Semen leukocytes: friends or foes? , 1995, Fertility and sterility.

[44]  E. Wallach,et al.  The biologic significance of white blood cells in semen. , 1995, Fertility and sterility.

[45]  A. Matsumoto Hormonal therapy of male hypogonadism. , 1994, Endocrinology and metabolism clinics of North America.

[46]  B. Lunenfeld,et al.  Sperm quality of subfertile males before and after treatment with human follicle‐stimulating hormone , 1994, Fertility and sterility.

[47]  D. Buckingham,et al.  Relationships between biochemical markers for residual sperm cytoplasm, reactive oxygen species generation, and the presence of leukocytes and precursor germ cells in human sperm suspensions , 1994, Molecular reproduction and development.

[48]  R. Quinton,et al.  Treatment of male infertility , 1994, The Lancet.

[49]  B. Lunenfeld,et al.  Sperm quality of subfertile males before and after treatment with human follicle-stimulating hormone , 1994 .

[50]  D. Anderson,et al.  Comparison of methods to enumerate white blood cells in semen. , 1993, Fertility and Sterility.

[51]  A. Bellmann,et al.  Differentiation of round cells in semen by means of monoclonal antibodies and relationship with male fertility. , 1992, Fertility and Sterility.

[52]  S. Oehninger,et al.  Pure human follicle stimulating hormone has a role in the treatment of severe male infertility by assisted reproduction: Norfolk's total experience. , 1992, Human reproduction.

[53]  I. Cooke,et al.  The removal of morphologically abnormal sperm forms by phagocytes: a positive role for seminal leukocytes? , 1992, Human reproduction.

[54]  G. Bonanni,et al.  Achievement of spermatogenesis and genital tract maturation in hypogonadotropic hypogonadic subjects during long term treatment with gonadotropins or LHRH , 2009, Andrologia.

[55]  S. Oehninger,et al.  Possible role of pure human follicle-stimulating hormone in the treatment of severe male-factor infertility by assisted reproduction: preliminary report. , 1991, Fertility and sterility.

[56]  W. Crowley,et al.  Clinical review 4: Diagnosis and treatment of isolated gonadotropin-releasing hormone deficiency in men. , 1990, The Journal of clinical endocrinology and metabolism.

[57]  D. C. Smith,et al.  The Characterisation of Non‐Sperm Cells in the Ejaculates of Fertile Men Using Transmission Electron Microscopy/Charakterisierung von nicht‐Spermatozoen‐Zellen in den Ejakulaten von fruchtbaren Männern unter Verwendung der Transmissions‐Elektronen‐Mikroskopie , 2009, Andrologia.

[58]  R. Sharpe Follicle-stimulating hormone and spermatogenesis in the adult male. , 1989, The Journal of endocrinology.

[59]  D. D. de Rooij,et al.  Follicle-stimulating hormone stimulates spermatogenesis in the adult monkey. , 1988, Endocrinology.

[60]  R. Elton,et al.  Leucocytes in the ejaculate from fertile and infertile men. , 1986, British journal of urology.

[61]  A. Matsumoto,et al.  Chronic human chorionic gonadotropin administration in normal men: evidence that follicle-stimulating hormone is necessary for the maintenance of quantitatively normal spermatogenesis in man. , 1986, The Journal of clinical endocrinology and metabolism.

[62]  A. Matsumoto,et al.  Stimulation of sperm production by human luteinizing hormone in gonadotropin-suppressed normal men. , 1984, The Journal of clinical endocrinology and metabolism.

[63]  A. Matsumoto,et al.  Reinitiation of sperm production in gonadotropin-suppressed normal men by administration of follicle-stimulating hormone. , 1983, The Journal of clinical investigation.

[64]  J. Courtens,et al.  Acrosomal and nuclear morphogenesis in ram spermatids: An experimental study of hypophysectomized and testosterone‐supplemented animals , 1980, The Anatomical record.

[65]  A. W. Endtz A rapid staining method for differentiating granulocytes from "germinal cells" in Papanicolaou-stained semen. , 1974, Acta cytologica.

[66]  E. Steinberger Hormonal control of mammalian spermatogenesis. , 1971, Physiological reviews.