Use of synthetic luteinizing hormone releasing hormone in treatment of oligospermic men: a preliminary report

Synthetic luteinizing hormone releasing hormone (LH RH) was administered to four normogonadotropic, oligospermic men (24 to 39 yr of age) who had no endocrinologic, urologic or associated vascular disease, to assess its possible therapeutic value in male infertility. Previous testicular biopsies of these subjects indicated alteration of spermiogenesis only. LH RH (mean dose, 500 μg/day) was administered intramuscularly for 100 to 135 days. Each patient had at least two sperm counts before starting therapy and had one every 20 to 30 days during and for two to five mth after treatment. The sperm count, semen volume, sperm motility and morphology, and seminal plasma concentrations of fructose and citric acid were studied in each semen sample. In three of the four patients, urinary LH and FSH excretion and plasma testosterone levels were also measured. The sperm count increased clearly in two subjects 30 to 80 days after therapy started; the response was small in the third subject and negative in the fourth. The remaining parameters followed variable courses. Libido increased in all subjects. In the post treatment period, the two patients who had shown the best response during treatment experienced a new and abrupt increase in the sperm count which remained well above initial values at the end of follow up. LH RH appears to be of value in the treatment of certain types of oligospermia, but several issues remain unsettled.