Gonadotropin administration after gonadotropin-releasing-hormone agonist: a therapeutic option in severe testiculopathies

摘要: Objective To evaluate the effect of recombinant human follicle-stimulating hormone (FSH) plus chorionic gonadotropin (hCG) on seminal parameters and pregnancy rate in severe testiculopathies after high FSH plasma concentrations have been suppressed. Design Prospective, controlled, randomized clinical study. Setting Infertility center at a university hospital. Patient(s) Eighty-seven men affected by testiculopathy. Intervention(s) We treated 57 with gonadotropin-releasing agonist (GnRH-a) then hCG, 30 patients did not receive any treatment. Seminal sperm aneuploidies were evaluated during treatment period. Couples achieve spontaneous received assisted reproduction Main Outcome Measure(s) parameters, aneuploidies, testicular cytologic analysis, FSH, luteinizing hormone, testosterone, inhibin B concentrations, rate. Result(s) After therapy period, group showed statistically significant improvement aneuploidies. No changes observed untreated group. A trend toward an increase also was among couples (cumulative rates 31.6% vs. 20.0% untreated), although significant. The allowed some to undergo vitro fertilization–embryo transfer instead intracytoplasmic injection. Conclusion(s) Results from this trial show that improves male factor infertility when endogenous levels are In cases severely impaired testicles, rational is mandatory improve outcome techniques.