Is it time to revisit follicle-stimulating hormone therapy in men with azoospermia?
Article In Press
Richard J. Fantus, M.D., Joshua A. Halpern, M.D., M.P.H., Robert E. Brannigan, M.D.
Although follicle-stimulating hormone (FSH) is necessary for male fertility, its pharmacologic use in infertile men has remained limited. Outside the use of recombinant or purified FSH therapy in hypogonadotropic hypogonadism, the use of therapeutic FSH remains controversial (1, 2). Several meta-analyses have attempted to investigate the use of FSH in different stages of male reproduction, but study heterogeneity often has been a limitation (2). Despite this heterogeneity, FSH treatment in these meta-analyses has shown improvements in semen parameters and live-birth rates among men with normogonadotropic idiopathic oligospermia, which has led to region-specific consensus statements (2). While this gives hope for the potential use of FSH, the therapeutic use of FSH in azoospermic men remains poorly investigated (2).