Reconsidering a Lower Level of Follicle-Stimulating Hormone as Abnormal in Sub-Fertile Males of Pakistan.

OBJECTIVE: To assess the association between Follicle-Stimulating Hormone (FSH) and semen parameters in order to evaluate whether the current laboratory reference for abnormal FSH levels should be readjusted.

STUDY DESIGN: Observational, cross-sectional study.

PLACE AND DURATION OF STUDY: Infertility Clinic of Gynecology Unit 1, Civil Hospital, Karachi, from May 2015 to April 2016.

METHODOLOGY: The study included 100 sub-fertile males inducted from the clinic. Those above 45 years of age, with hypo gonadotrophic hypogonadism, and those on anabolic steroids were excluded. After history and examination, semen parameters and FSH levels were tested. Abnormal semen values were based on WHO 1999 criteria. Data was analyzed by SPSS 17 and mean, frequencies and percentages were calculated. Chi-square test was applied to check association between variables.

RESULTS: The FSH levels had a significant association with abnormal semen sperm concentration, motility and morphology but not with semen volume (p=0.246). The mean FSH level was 5.8 ±1.80 IU/Lwith two-thirds of individuals having value >4.5 IU/L. Frequency of semen abnormalities increased as the level of FSH increased.

CONCLUSION: There is significantly an increased possibility of abnormal semen characteristics at FSH levels >4.5, so the current reference level should be lowered down and adjusted again.