FSH treatment for normogonadotropic male infertility: a synergistic role for metformin?

S. La Vignera, R.A. Condorelli, Y. Duca, R. Cannarella, F. Giacone, A.E. Calogero

Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy. sandrolavignera@unict.it

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• Pharmacology

OBJECTIVE: The aim of this paper is to evaluate the effectiveness of follicle-stimulating hormone (FSH) administration in a cohort of insulin resistant (HOMA>2.5) patients with normogonadotropic idiopathic infertility.

PATIENTS AND METHODS: We subdivided patients in two clinical groups basing on the adopted therapeutic scheme: group A (n=44) received 150 units of FSH three times a week for three months (group A); group B (n=35) received 150 units of FSH three times a week for three months and 500 mg of slow-release metformin once a day for three months (group B). We evaluated the post-treatment sperm parameters, sperm parameters normalization rate, spontaneous pregnancy rate, and sperm DNA fragmentation normalization rate.

RESULTS: 40% of group A patients and 45% of group B patients became normozoospermic after the treatment, while 30% of group A patients and 32% of group B patients achieved a spontaneous pregnancy. B group patients also obtained higher sperm DNA fragmentation normalization rate (45% vs. 33%, p = 0.03). Compared to group A, group B showed a higher sperm concentration, progressive motility and morphology (p < 0.0001).

CONCLUSIONS: The results of this study suggest that the addition of the low-dose slow-release metformin in insulin-resistant patients with normogonadotropic infertility improves the efficacy of FSH therapy.

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