ASSOCIATION BETWEEN FOLLICLE STIMULATING HORMONE (FSH) AND BASELINE SEMEN PARAMETER ABNORMALITIES IN MEN PRESENTING FOR FERTILITY EVALUATION.

To investigate the association between follicle stimulating hormone (FSH) levels and semen parameter abnormalities at initial infertility evaluation. This retrospective cohort study evaluated all men who presented to a tertiary care center for an initial infertility evaluation. Men who completed a semen analysis (SA) and had measured testosterone and FSH levels were included. Men with an incomplete evaluation or a history of vasectomy were excluded. Semen parameters were considered normal or abnormal based on the World Health Organization’s Laboratory Manual, 5th edition. Basic descriptive statistics were used to analyze median FSH values for men with normal versus abnormal semen parameters (volume, concentration, motility, and morphology). Mann-Whitney U tests and Kruskal-Wallis tests were used where appropriate with statistical significance defined as P < 0.05. A total of 4,177 men met inclusion criteria and were evaluated in this study. The median FSH at the time of initial presentation was 7.13 (interquartile range [IQR] 3.1-7.7). Men initially presenting with abnormal sperm concentrations had higher median FSH levels compared to those men with normal sperm concentrations (10.31 [IQR 3.9-12.3] vs 4.52 [IQR 2.8-5.5], P < 0.01, respectively). FSH was also higher among men with abnormal sperm motility and morphology (both P < 0.01). Men with 0, 1, 2, 3 or 4 seminal abnormalities had median FSHs of 4.38 (IQR 2.7-5.4), 5.74 (IQR 3.2-7.0), 5.82 (IQR 3.3-8.3), 13.11 (IQR 4.4-18.3), and 11.23 (IQR 3.6-12.2) respectively (P<0.01). In adult men undergoing an infertility evaluation, elevated FSH levels were associated with abnormalities in sperm concentration, motility and morphology.