Mp42-02 Effects of the Combination of Different FSH Molecules on Sperm Parameters and Pregnancy: A Prospective Controlled Study

You have accessJournal of UrologyInfertility: Therapy (MP42)1 May 2024MP42-02 EFFECTS OF THE COMBINATION OF DIFFERENT FSH MOLECULES ON SPERM PARAMETERS AND PREGNANCY: A PROSPECTIVE CONTROLLED STUDY Rossella Cannarella, Claudia Leanza, Andrea Crafa, Antonio Aversa, Rosita A. Condorelli, Scott D. Lundy, Aldo E. Calogero, and Sandro La Vignera Rossella CannarellaRossella Cannarella , Claudia LeanzaClaudia Leanza , Andrea CrafaAndrea Crafa , Antonio AversaAntonio Aversa , Rosita A. CondorelliRosita A. Condorelli , Scott D. LundyScott D. Lundy , Aldo E. CalogeroAldo E. Calogero , and Sandro La VigneraSandro La Vignera View All Author Informationhttps://doi.org/10.1097/01.JU.0001008688.39367.31.02AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: FSH is often prescribed in men with oligozoospermia or hypogonadotropic hypogonadism, but numerous formulations are available and little is known about whether one agent is superior or whether a failure within this class of medications predicts failure with another agent. The objective of this study was to evaluate the effect of switching to a different FSH molecule from the one to which male infertile patients showed a lack of response. METHODS: In this prospective controlled study, 74 infertile patients with non-obstructive alterations in sperm parameters and normal gonadotropin levels who did not respond to treatment with highly purified FSH (hpFSH) Group 1 (n=22) and Group 3 (n=15) or to recombinant human FSH (rhFSH) Group 2 (n=22) and Group 4 (n=15) were enrolled. After 3 months of washout, rhFSH was prescribed to patients in Groups 1 and 4 and hpFSH to those in Groups 2 and 3, at a dose of 150 IU three times a week for three months. Patients in Groups 3 and 4 continued the treatment with the same FSH molecule with which they had started, acting as controls. The endpoints of the study were conventional sperm parameters and the number of pregnancies achieved, luteinizing hormone (LH), FSH, total testosterone (TT), and testicular volume, which were assessed before starting treatment and after first and second cycle of treatment. RESULTS: At baseline, the groups did not differ on any of the study endpoints. After the first cycle of treatment, no pregnancy was recorded in all groups, highlighting the poor responsiveness to therapy. In intragroup analysis, the switched groups (Groups 1 and 2) showed a significant improvement in sperm concentration, total sperm count (TSC), progressive motility, and morphology, while the non-switched groups presented an improvement in sperm concentration and TSC compared to baseline. In the inter-group comparison, the greatest improvement in sperm parameters was obtained by the groups in which the FSH molecule was changed for the second treatment cycle. Group 1 showed the greatest benefit from the therapy, recording a higher percentage of pregnancies after the second treatment cycle, with 8 patients achieving a pregnancy (36.4%), compared to Groups 2 (n=4; 18.2%), 3 (n=1; 6.7%), and 4 (n=2; 13.3%) (p=0.04). CONCLUSIONS: These results suggest the superiority of the "switching" scheme compared to treatment with the same FSH molecule for six months. hpFSH for 3 months followed by treatment with rhFSH for the other three months, both at a dose of 150 IU three times a week, seems the best therapeutic option. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e684 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Rossella Cannarella More articles by this author Claudia Leanza More articles by this author Andrea Crafa More articles by this author Antonio Aversa More articles by this author Rosita A. Condorelli More articles by this author Scott D. Lundy More articles by this author Aldo E. Calogero More articles by this author Sandro La Vignera More articles by this author Expand All Advertisement PDF downloadLoading ...