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Hum. Reprod. Advance Access published online on March 13, 2008
Human Reproduction, doi:10.1093/humrep/den046
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© The Author 2008. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Seminal anti-Müllerian hormone level is a marker of spermatogenic response during long-term gonadotropin therapy in male hypogonadotropic hypogonadism

A.A. Sinisi1,3, D. Esposito1, L. Maione1, M.C. Quinto1, D. Visconti1, A. De Bellis1, A. Bellastella1, G. Conzo2 and G. Bellastella1

1 Endocrinology and Medical Andrology Section, Department of Clinical and Experimental Medicine and Surgery, Seconda Università di Napoli, Build 16, Via Pansini 5, 80131 Napoli, Italy 2 Endocrine Surgery Section, Department of Clinical and Experimental Medicine and Surgery, Seconda Università di Napoli, 80131 Napoli, Italy

3Correspondence address. Tel/Fax: +39-0815666627; E-mail: antonio.sinisi{at}unina2.it

BACKGROUND: In adult men, anti-Müllerian hormone (AMH) levels are higher in semen than in serum, but the significance and control of its seminal secretion are still unknown. This study evaluated seminal and serum AMH levels during long-term gonadotropin therapy in men with hypogonadotropic hypogonadism (HH).

METHODS: A total of 20 men with never treated prepubertal-onset HH received i.m. hCG to normalize testosterone (T) and induce puberty. Afterwards, 11 of them, requiring fertility, were treated with HCG plus recombinant FSH (rFSH) (75 IU) twice a week, whereas 9 continued to receive hCG alone for 12 months. Before and during therapy, serum AMH, inhibin B and T levels were assessed. Semen samples were also collected during therapy for sperm count and seminal AMH assay.

RESULTS: HCG alone decreased basal high serum AMH and stimulated T and inhibin B levels. rFSH plus hCG increased seminal AMH levels, which were consequently significantly higher than with hCG alone, and positively correlated to sperm densities and testicular volumes at 3 and 12 months (P < 0.001).

CONCLUSIONS: Our data demonstrate that rFSH, added to hCG, stimulates seminal AMH and spermatogenesis in HH. Thus, seminal AMH levels are under T and FSH control and are closely related to progression of spermatogenesis. Our results also suggest that an early seminal AMH increase may be a marker of good future response to gonadotropin therapy in HH.

Key words: AMH/hypogonadotropic hypogonadism/spermatogenesis/recombinant FSH/Sertoli cells

Submitted on October 31, 2007; resubmitted on January 21, 2008; accepted on January 30, 2008.


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