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. Introduction Follicle-stimulating hormone has an important role in testicular function. In particular, its main biological actions (mediated through a receptor system present on the Sertoli cells) are the following: cellular sperm differentiation, modulation of spermatid morphogenesis, and the maturation of epididymal spermatozoa [1–10]. The biological actions of FSH are more relevant in the clinical condition of hypogonadotropic hypogonadism [5, 11–16] and are more controversial in functional hypogonadism and/or in patients with idiopathic oligoasthenoteratozoospermia (OAT) [17–27]. Functional hypogonadism is defined as a clinical condition in which the gonadotropin levels are in the low-normal range but the testosterone level is inadequate (or often in the low-normal range) [28]. Idiopathic OAT means that no etiological factor can be found by common clinical, instrumental, or laboratory methods [29]. The demonstrated biological effects of FSH treatment in male infertile patients are increased spermatogonial population and sperm count, [17–21], increased rate of fertilization, and increased pregnancy rate in programs of assisted fertilization [22–24]. However, several studies
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