Male-factor infertility patients with severe impairment of sperm parameters of ten do not achieve fertilization in the in vitro fertilization(IVF) system. Different techniques of assisted fertilization such as micromanipulation have been proposed
to
overcome this problem, but the success rate is till very low, and they have a high degree of complexity. Theoretically, treatment of male-factor infertility with the pure follicle-stimulating hormone(FSH) may provide adequate endocrine
stimulation
to
the Sertoli cell to enhance its FSH-dependent function and to support spermatogenesis, and with the human chorionic gonadotropin (hCG) may increase the concentration of intratesticular testosterone(T) and enhance promptly initiation of
spermatogensis.
The objective of this study is to determine the effect of the systemic pure FSH/hCG on endocrine and semen parameters and to assess the potential of this therapy to improve sperm fertilizing ability in IVF.
From March 1991 to July 1992, Two groups of severe male-factor patients were evaluated ; patients with poor sperm parameters, indicating that fertilization would not occurred at all (group I) and the cases with a history of total unfertilization
in
previous IVF attempts(group II). The patients in both group were administered FSH-hCG for at least 3 months. The wives of patients were performed in controlled ovarian hyperstimulation with human menpausal gonadotropins(hMG) including
gonaotropin-releasing hormone agonist (GnRH-a) long protocol or modified ultrashort GnRH-a protocol.
@ES The result were as follows:
@EN 1. The rates of normal fertilization and of delayed fertilization in group I were respectively 16.08%(32/199) and 5.03(10/199).
2. The rate of total unfertilization cycles and of pregnancies in group I were respectively 47.4%(9/19)and 15.8(3/9).
3. In group II, the rate of normal fertilization after hormonal treatment (17.4%, 27/161) was significantly higher than before hormonal treatment(8.8%, 15/70) (P<0.05).
4. In group II, no pregnancy was in patients before hormonal treatment, but 3 pregnancies were achieved in patients after hormonal treatment.
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