The use of FSH in adolescents and young adults with left idiopathic varicocele, not submitted to surgery. Preliminary study

BACKGROUND: To study gonadal function in young patients suffering from left varicocele. METHODS: Design: prospective study. Setting: university laboratory and clinical services. patients: 20 boys (age range: 15-20 yrs; mean +/- DS: 17.9 +/- 1.48 yrs), affected by left idiopathic varicocele. Intervention: high purified urinary FSH s.c. (Metrodin HP 75, Ares-Serono), three times every week, for three months. Main outcome measures: seminal fluid examination before and after therapy (WHO). RESULTS: At the end of the study period a statistically increase of sperm density/ml (38.45 x 10(6) vs 49.10 x 10(6)), total sperm number/ejaculate with forward motility (37.41 x 10(6) vs 48.52 x 10(6)) and a decrease of atypical forms (54.35% vs 49.60%) has been observed; the increase of the total sperm number/ejaculate after FSH treatment greater than 50% compared with basal values allows to define 9 patients as responders. CONCLUSIONS: In this study the FSH treatment in young people with varicocele leads to a statistically significant increase in the seminal fluid parameters and may characterize a group of patients who may have a better prognostic outcome regarding the tubular gonadal function and thus the fertility potential in adult life.