Role of Follicle-stimulating hormone (FSH) and Testosterone in abnormal sperm parameters – A review article
Main Article Content
Abstract
Follicle-stimulating hormone (FSH) and testosterone are essential for the spermatogenesis. FSH acts on FSH receptor (FSHR) present in Sertoli cells to support spermatogenesis. Luteinizing hormone (LH) act on Leydig cells which stimulates testosterone production which completes the spermatogenesis. Their levels are regulated by a negative feedback loop to balance the hormone production. The balanced levels of these hormones are essential for maintaining the sperm parameters. In case of excessive or deficiency of FSH and testosterone levels, sperm quantity and quality got affected and lead to male infertility. In male factor infertility with low to normal FSH and testosterone levels, FSH supplements with or without LH or Human chorionic gonadotropins (HCG) supplements can maintain spermatogenesis even in presence of low levels of testosterone. Only testosterone replacement therapy can suppress of FSH and LH that can lead to decrease in semen parameters and male infertility. Also, high level of testosterone can damage the sperm and can lead to male infertility. In this article, role of FSH and testosterone in abnormal semen parameters had been explained and type of hormonal therapy which can be beneficial in these cases.
Article Details
How to Cite
SINGLA, Bhavana.
Role of Follicle-stimulating hormone (FSH) and Testosterone in abnormal sperm parameters – A review article.
Medical Research Archives, [S.l.], v. 13, n. 11, dec. 2025.
ISSN 2375-1924.
Available at: <https://esmed.org/MRA/mra/article/view/7075>. Date accessed: 05 dec. 2025.
doi: https://doi.org/10.18103/mra.v13i11.7075.
Section
Review Articles
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
References
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https://www.ncbi.nlm.nih.gov/books/NBK562258/
2. World Health Organization. Geneva: WHO Press; 2010. Laboratory Manual for the Examination and Processing of Human Semen, 5th ed.
3. Ramaswamy S, Weinbauer GF. Endocrine control of spermatogenesis: Role of FSH and LH/ testosterone. Spermatogenesis. 2015 Jan 26;4(2): e996025. doi: 10.1080/21565562.2014.996025. PMID: 26413400; PMCID: PMC4581062.
4. Klein CE. The Hypothalamic-Pituitary-Gonadal Axis. In: Kufe DW, Pollock RE, Weichselbaum RR, et al., editors. Holland-Frei Cancer Medicine. 6th edition. Hamilton (ON): BC Decker; 2003. Available from: https://www.ncbi.nlm.nih.gov/books/NBK13386/
5. Khanehzad M, Abbaszadeh R, Holakuyee M, Modarressi MH, Nourashrafeddin SM. FSH regulates RA signaling to commit spermatogonia into differentiation pathway and meiosis. Reprod Biol Endocrinol. 2021;19:4.
6. Wang, JM., Li, ZF., Yang, WX. et al. Follicle-stimulating hormone signaling in Sertoli cells: a licence to the early stages of spermatogenesis. Reprod Biol Endocrinol 20, 97 (2022).
https://doi.org/10.1186/s12958-022-00971-w
7. Sharpe RM, McKinnell C, Kivlin C, Fisher JS. Proliferation and functional maturation of Sertoli cells, and their relevance to disorders of testis function in adulthood. Reproduction. 2003 Jun;125(6):769-84. doi: 10.1530/rep.0.1250769. PMID: 12773099.
8. Das N, Kumar TR. Molecular regulation of follicle-stimulating hormone synthesis, secretion and action. J Mol Endocrinol. 2018 Apr;60(3):R131-R155. doi: 10.1530/JME-17-0308. Epub 2018 Feb 7. PMID: 29437880; PMCID: PMC5851872.
9. Allan CM, Garcia A, Spaliviero J, Zhang FP, Jimenez M, Huhtaniemi I, et al. Complete Sertoli cell proliferation induced by follicle-stimulating hormone (FSH) independently of luteinizing hormone activity: evidence from genetic models of isolated FSH action. Endocrinology (2004) 145:1587–93. 10.1210/en.2003-1164
10. Zimmermann C, Stévant I, Borel C, Conne B, Pitetti JL, Calvel P, Kaessmann H, Jégou B, Chalmel F, Nef S. Research resource: the dynamic transcriptional profile of sertoli cells during the progression of spermatogenesis. Mol Endocrinol. 2015 Apr;29(4):627-42. doi: 10.1210/me.2014-1356. Epub 2015 Feb 24. PMID: 25710594; PMCID: PMC5414748.
11. Layman LC, Porto AL, Xie J, da Motta LA, da Motta LD, Weiser W, Sluss PM. FSH beta gene mutations in a female with partial breast development and a male sibling with normal puberty and azoospermia. J Clin Endocrinol Metab. 2002;87:3702–7.
12. Zheng J, Mao J, Cui M, Liu Z, Wang X, Xiong S, Nie M, Wu X. Novel FSHβ mutation in a male patient with isolated FSH deficiency and infertility. Eur J Med Genet. 2017;60:335–9.
13. Walker WH. Testosterone Signaling and the Regulation of Spermatogenesis. Spermatogenesis (2011) 1(2):116–20. doi: 10.4161/spmg.1.2.16956
14. Miller WL. Early steps in androgen biosynthesis: from cholesterol to DHEA. Baillieres Clin Endocrinol Metab. 1998 Apr;12(1):67-81.
15. Roth M.Y., Lin K., Amory J.K., Matsumoto A.M., Anawalt B.D., Snyder C.N., Kalhorn T.F., Bremner W.J., Page S.T. Serum LH correlates highly with intratesticular steroid levels in normal men. J. Androl. 2010;31:138–145. doi: 10.2164/jandrol.10 9.008391.
16. Mruk D.D., Cheng C.Y. Sertoli-Sertoli and Sertoli-germ cell interactions and their significance in germ cell movement in the seminiferous epithelium during spermatogenesis.
17. Sofikitis N, Giotitsas N, Tsounapi P, Baltogiannis D, Giannakis D, Pardalidis N. Hormonal Regulation of Spermatogenesis and Spermiogenesis. J Steroid Biochem Mol Biol (2008) 109(3–5):323–30. doi: 10.1016/j.jsbmb.2008.03.004
18. Grande G, Barrachina F, Soler-Ventura A, Jodar M, Mancini F, Marana R, Chiloiro S, Pontecorvi A, Oliva R, Milardi D. The Role of Testosterone in Spermatogenesis: Lessons From Proteome Profiling of Human Spermatozoa in Testosterone Deficiency. Front Endocrinol (Lausanne). 2022 May 19;13:852661. doi: 10.3389/fendo.2022.852661. PMID: 35663320; PMCID: PMC9161277.
19. Smith LB, Walker WH. The regulation of spermatogenesis by androgens. Semin Cell Dev Biol. 2014 Jun;30:2-13. doi: 10.1016/j.semcdb.201 4.02.012. Epub 2014 Mar 2. PMID: 24598768; PMCID: PMC4043871.
20. Nassar GN, Leslie SW. Physiology, Testosterone. [Updated 2023 Jan 2]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK526128/
21. Freeman ER, Bloom DA, McGuire EJ. A brief history of testosterone. J Urol. 2001 Feb;165(2):371-3. doi: 10.1097/00005392-200102000-00004. PMID: 11176375.
22. Oren I, Fleishman SJ, Kessel A, Ben-Tal N. Free diffusion of steroid hormones across biomembranes: a simplex search with implicit solvent model calculations. Biophys J. 2004 Aug;87(2):768-79. doi: 10.1529/biophysj.103.035527. PMID: 15298886; PMCID: PMC1304487.
23. Tesarik J, Martinez F, Rienzi L, Iacobelli M, Ubaldi F, Mendoza C, Greco E. In-vitro effects of FSH and testosterone withdrawal on caspase activation and DNA fragmentation in different cell types of human seminiferous epithelium. Hum Reprod. 2002 Jul;17(7):1811-9. doi: 10.1093/humr ep/17.7.1811. PMID: 12093844.
24. Zalata AA, Mokhtar N, Badawy Ael-N, Othman G, Alghobary M, Mostafa T. Androgen receptor expression relationship with semen variables in infertile men with varicocele. J Urol. 2013 Jun;189 (6):2243-7. doi: 10.1016/j.juro.2012.11.112. Epub 2012 Nov 28. PMID: 23201383.
25. Sanocka D, Kurpisz M. Reactive oxygen species and sperm cells. Reprod Biol Endocrinol. 2004 Mar 23;2:12. doi: 10.1186/1477-7827-2-12. PMID: 150 38829; PMCID: PMC400757.
26. Vasconsuelo A, Pronsato L, Ronda AC, Boland R, Milanesi L. Role of 17β-estradiol and testosterone in apoptosis. Steroids. 2011 Nov;76(12):1223-31. doi: 10.1016/j.steroids.2011.08.001. Epub 2011 Aug 10. PMID: 21855557.
27. Mohammadzadeh M, Montazeri F, Poodineh J, Vatanparast M, Rahmanian Koshkaki E, Ghasemi Esmailabad S, Mohseni F, Talebi AR. Therapeutic potential of testosterone on sperm parameters and chromatin status in fresh and thawed normo and asthenozoospermic samples. Rev Int Androl. 2023 Jul-Sep;21(3):100352. doi: 10.1016/j.androl.202 3.100352. Epub 2023 May 25. PMID: 37244225.
28. Di Guardo F, Vloeberghs V, Bardhi E, Blockeel C, Verheyen G, Tournaye H, Drakopoulos P. Low Testosterone and Semen Parameters in Male Partners of Infertile Couples Undergoing IVF with a Total Sperm Count Greater than 5 Million. J Clin Med. 2020 Nov 26;9(12):3824. doi: 10.3390/jcm9123824. PMID: 33255908; PMCID: PMC7761260.
29. Trussell JC, Coward RM, Santoro N, Stetter C, Kunselman A, Diamond MP, Hansen KR, Krawetz SA, Legro RS, Heisenleder D, Smith J, Steiner A, Wild R, Casson P, Coutifaris C, Alvero RR, Robinson RB, Christman G, Patrizio P, Zhang H, Lindgren MC; Reproductive Medicine Network. Association between testosterone, semen parameters, and live birth in men with unexplained infertility in an intrauterine insemination population. Fertil Steril. 2019 Jun;111(6):1129-1134. doi: 10.1016/j.fertnste rt.2019.01.034. Epub 2019 Apr 12. PMID: 30982604; PMCID: PMC6557574.
30. Mancini A, Raimondo S, Persano M, Di Segni C, Cammarano M, Gadotti G, Silvestrini A, Pontecorvi A, Meucci E. Estrogens as antioxidant modulators in human fertility. Int J Endocrinol. 2013;2013: 607939. doi: 10.1155/2013/607939. Epub 2013 Nov 20. PMID: 24363671; PMCID: PMC3863713.
31. Valenti D, La Vignera S, Condorelli RA, Rago R, Barone N, Vicari E, Calogero AE. Follicle-stimulating hormone treatment in normogonadotropic infertile men. Nat Rev Urol. 2013 Jan;10(1):55-62. doi: 10.1038/nrurol.2012.234. Epub 2012 Dec 11. PMID: 23229508.
32. Cannarella R, La Vignera S, Condorelli RA, Mongioì LM, Calogero AE. FSH dosage effect on conventional sperm parameters: a meta-analysis of randomized controlled studies. Asian J Androl. 2020 May-Jun;22(3):309-316. doi: 10.4103/aja.aja_42_19. PMID: 31274479; PMCID: PMC7275804.
33. Shiraishi K, Matsuyama H. Gonadotoropin actions on spermatogenesis and hormonal therapies for spermatogenic disorders [Review]. Endocr J. 2017 Feb 27;64(2):123-131. doi: 10.1507/endocrj.EJ17-0001. Epub 2017 Jan 19. PMID: 28100869.
34. Esteves SC, Humaidan P. The role of luteinizing hormone activity in spermatogenesis: from physiology to clinical practice. Reprod Biol Endocrinol. 2025 Jan 13;23(Suppl 1):6. doi: 10.1186/s12958-024-01333-4. PMID: 39800700; PMCID: PMC11726975.
35. Ho CC, Tan HM. Treatment of the Hypogonadal Infertile Male-A Review. Sex Med Rev. 2013 May;1 (1):42-49. doi: 10.1002/smrj.4. Epub 2015 Oct 21. PMID: 27784559.
36. Casarini L, Crépieux P, Reiter E, Lazzaretti C, Paradiso E, Rochira V, Brigante G, Santi D, Simoni M. FSH for the Treatment of Male Infertility. Int J Mol Sci. 2020 Mar 25;21(7):2270. doi: 10.3390/ijms21 072270. PMID: 32218314; PMCID: PMC7177393.
37. Masterson TA, Turner D, Vo D, Blachman-Braun R, Best JC, Westfield G, Bryson N, Ramasamy R. The Effect of Longer-Acting vs Shorter-Acting Testosterone Therapy on Follicle Stimulating Hormone and Luteinizing Hormone. Sex Med Rev. 2021 Jan;9(1):143-148. doi: 10.1016/j.sxmr.2020.0 7.006. Epub 2020 Sep 8. PMID: 32912767.
38. Greenberg DR, Hudnall MT, Goyette BN, Lai JD, Hayon S, Bennett NE, Brannigan RE, Halpern JA. Assessing the Prevalence of Low Testosterone and Elevated Follicle Stimulating Hormone Among Men Presenting for Fertility Evaluation Without Oligospermia. Urology. 2023 Oct;180:130-134. doi: 10.1016/j.urology.2023.07.011. Epub 2023 Jul 22. PMID: 37482101.
39. Casarini L, Lispi M, Longobardi S, Milosa F, La Marca A, Tagliasacchi D, et al. LH and hCG action on the same receptor results in quantitatively and qualitatively different intracellular signalling. PLoS ONE. (2012) 7:e46682. doi: 10.1371/journal.pone.0 046682
https://www.ncbi.nlm.nih.gov/books/NBK562258/
2. World Health Organization. Geneva: WHO Press; 2010. Laboratory Manual for the Examination and Processing of Human Semen, 5th ed.
3. Ramaswamy S, Weinbauer GF. Endocrine control of spermatogenesis: Role of FSH and LH/ testosterone. Spermatogenesis. 2015 Jan 26;4(2): e996025. doi: 10.1080/21565562.2014.996025. PMID: 26413400; PMCID: PMC4581062.
4. Klein CE. The Hypothalamic-Pituitary-Gonadal Axis. In: Kufe DW, Pollock RE, Weichselbaum RR, et al., editors. Holland-Frei Cancer Medicine. 6th edition. Hamilton (ON): BC Decker; 2003. Available from: https://www.ncbi.nlm.nih.gov/books/NBK13386/
5. Khanehzad M, Abbaszadeh R, Holakuyee M, Modarressi MH, Nourashrafeddin SM. FSH regulates RA signaling to commit spermatogonia into differentiation pathway and meiosis. Reprod Biol Endocrinol. 2021;19:4.
6. Wang, JM., Li, ZF., Yang, WX. et al. Follicle-stimulating hormone signaling in Sertoli cells: a licence to the early stages of spermatogenesis. Reprod Biol Endocrinol 20, 97 (2022).
https://doi.org/10.1186/s12958-022-00971-w
7. Sharpe RM, McKinnell C, Kivlin C, Fisher JS. Proliferation and functional maturation of Sertoli cells, and their relevance to disorders of testis function in adulthood. Reproduction. 2003 Jun;125(6):769-84. doi: 10.1530/rep.0.1250769. PMID: 12773099.
8. Das N, Kumar TR. Molecular regulation of follicle-stimulating hormone synthesis, secretion and action. J Mol Endocrinol. 2018 Apr;60(3):R131-R155. doi: 10.1530/JME-17-0308. Epub 2018 Feb 7. PMID: 29437880; PMCID: PMC5851872.
9. Allan CM, Garcia A, Spaliviero J, Zhang FP, Jimenez M, Huhtaniemi I, et al. Complete Sertoli cell proliferation induced by follicle-stimulating hormone (FSH) independently of luteinizing hormone activity: evidence from genetic models of isolated FSH action. Endocrinology (2004) 145:1587–93. 10.1210/en.2003-1164
10. Zimmermann C, Stévant I, Borel C, Conne B, Pitetti JL, Calvel P, Kaessmann H, Jégou B, Chalmel F, Nef S. Research resource: the dynamic transcriptional profile of sertoli cells during the progression of spermatogenesis. Mol Endocrinol. 2015 Apr;29(4):627-42. doi: 10.1210/me.2014-1356. Epub 2015 Feb 24. PMID: 25710594; PMCID: PMC5414748.
11. Layman LC, Porto AL, Xie J, da Motta LA, da Motta LD, Weiser W, Sluss PM. FSH beta gene mutations in a female with partial breast development and a male sibling with normal puberty and azoospermia. J Clin Endocrinol Metab. 2002;87:3702–7.
12. Zheng J, Mao J, Cui M, Liu Z, Wang X, Xiong S, Nie M, Wu X. Novel FSHβ mutation in a male patient with isolated FSH deficiency and infertility. Eur J Med Genet. 2017;60:335–9.
13. Walker WH. Testosterone Signaling and the Regulation of Spermatogenesis. Spermatogenesis (2011) 1(2):116–20. doi: 10.4161/spmg.1.2.16956
14. Miller WL. Early steps in androgen biosynthesis: from cholesterol to DHEA. Baillieres Clin Endocrinol Metab. 1998 Apr;12(1):67-81.
15. Roth M.Y., Lin K., Amory J.K., Matsumoto A.M., Anawalt B.D., Snyder C.N., Kalhorn T.F., Bremner W.J., Page S.T. Serum LH correlates highly with intratesticular steroid levels in normal men. J. Androl. 2010;31:138–145. doi: 10.2164/jandrol.10 9.008391.
16. Mruk D.D., Cheng C.Y. Sertoli-Sertoli and Sertoli-germ cell interactions and their significance in germ cell movement in the seminiferous epithelium during spermatogenesis.
17. Sofikitis N, Giotitsas N, Tsounapi P, Baltogiannis D, Giannakis D, Pardalidis N. Hormonal Regulation of Spermatogenesis and Spermiogenesis. J Steroid Biochem Mol Biol (2008) 109(3–5):323–30. doi: 10.1016/j.jsbmb.2008.03.004
18. Grande G, Barrachina F, Soler-Ventura A, Jodar M, Mancini F, Marana R, Chiloiro S, Pontecorvi A, Oliva R, Milardi D. The Role of Testosterone in Spermatogenesis: Lessons From Proteome Profiling of Human Spermatozoa in Testosterone Deficiency. Front Endocrinol (Lausanne). 2022 May 19;13:852661. doi: 10.3389/fendo.2022.852661. PMID: 35663320; PMCID: PMC9161277.
19. Smith LB, Walker WH. The regulation of spermatogenesis by androgens. Semin Cell Dev Biol. 2014 Jun;30:2-13. doi: 10.1016/j.semcdb.201 4.02.012. Epub 2014 Mar 2. PMID: 24598768; PMCID: PMC4043871.
20. Nassar GN, Leslie SW. Physiology, Testosterone. [Updated 2023 Jan 2]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK526128/
21. Freeman ER, Bloom DA, McGuire EJ. A brief history of testosterone. J Urol. 2001 Feb;165(2):371-3. doi: 10.1097/00005392-200102000-00004. PMID: 11176375.
22. Oren I, Fleishman SJ, Kessel A, Ben-Tal N. Free diffusion of steroid hormones across biomembranes: a simplex search with implicit solvent model calculations. Biophys J. 2004 Aug;87(2):768-79. doi: 10.1529/biophysj.103.035527. PMID: 15298886; PMCID: PMC1304487.
23. Tesarik J, Martinez F, Rienzi L, Iacobelli M, Ubaldi F, Mendoza C, Greco E. In-vitro effects of FSH and testosterone withdrawal on caspase activation and DNA fragmentation in different cell types of human seminiferous epithelium. Hum Reprod. 2002 Jul;17(7):1811-9. doi: 10.1093/humr ep/17.7.1811. PMID: 12093844.
24. Zalata AA, Mokhtar N, Badawy Ael-N, Othman G, Alghobary M, Mostafa T. Androgen receptor expression relationship with semen variables in infertile men with varicocele. J Urol. 2013 Jun;189 (6):2243-7. doi: 10.1016/j.juro.2012.11.112. Epub 2012 Nov 28. PMID: 23201383.
25. Sanocka D, Kurpisz M. Reactive oxygen species and sperm cells. Reprod Biol Endocrinol. 2004 Mar 23;2:12. doi: 10.1186/1477-7827-2-12. PMID: 150 38829; PMCID: PMC400757.
26. Vasconsuelo A, Pronsato L, Ronda AC, Boland R, Milanesi L. Role of 17β-estradiol and testosterone in apoptosis. Steroids. 2011 Nov;76(12):1223-31. doi: 10.1016/j.steroids.2011.08.001. Epub 2011 Aug 10. PMID: 21855557.
27. Mohammadzadeh M, Montazeri F, Poodineh J, Vatanparast M, Rahmanian Koshkaki E, Ghasemi Esmailabad S, Mohseni F, Talebi AR. Therapeutic potential of testosterone on sperm parameters and chromatin status in fresh and thawed normo and asthenozoospermic samples. Rev Int Androl. 2023 Jul-Sep;21(3):100352. doi: 10.1016/j.androl.202 3.100352. Epub 2023 May 25. PMID: 37244225.
28. Di Guardo F, Vloeberghs V, Bardhi E, Blockeel C, Verheyen G, Tournaye H, Drakopoulos P. Low Testosterone and Semen Parameters in Male Partners of Infertile Couples Undergoing IVF with a Total Sperm Count Greater than 5 Million. J Clin Med. 2020 Nov 26;9(12):3824. doi: 10.3390/jcm9123824. PMID: 33255908; PMCID: PMC7761260.
29. Trussell JC, Coward RM, Santoro N, Stetter C, Kunselman A, Diamond MP, Hansen KR, Krawetz SA, Legro RS, Heisenleder D, Smith J, Steiner A, Wild R, Casson P, Coutifaris C, Alvero RR, Robinson RB, Christman G, Patrizio P, Zhang H, Lindgren MC; Reproductive Medicine Network. Association between testosterone, semen parameters, and live birth in men with unexplained infertility in an intrauterine insemination population. Fertil Steril. 2019 Jun;111(6):1129-1134. doi: 10.1016/j.fertnste rt.2019.01.034. Epub 2019 Apr 12. PMID: 30982604; PMCID: PMC6557574.
30. Mancini A, Raimondo S, Persano M, Di Segni C, Cammarano M, Gadotti G, Silvestrini A, Pontecorvi A, Meucci E. Estrogens as antioxidant modulators in human fertility. Int J Endocrinol. 2013;2013: 607939. doi: 10.1155/2013/607939. Epub 2013 Nov 20. PMID: 24363671; PMCID: PMC3863713.
31. Valenti D, La Vignera S, Condorelli RA, Rago R, Barone N, Vicari E, Calogero AE. Follicle-stimulating hormone treatment in normogonadotropic infertile men. Nat Rev Urol. 2013 Jan;10(1):55-62. doi: 10.1038/nrurol.2012.234. Epub 2012 Dec 11. PMID: 23229508.
32. Cannarella R, La Vignera S, Condorelli RA, Mongioì LM, Calogero AE. FSH dosage effect on conventional sperm parameters: a meta-analysis of randomized controlled studies. Asian J Androl. 2020 May-Jun;22(3):309-316. doi: 10.4103/aja.aja_42_19. PMID: 31274479; PMCID: PMC7275804.
33. Shiraishi K, Matsuyama H. Gonadotoropin actions on spermatogenesis and hormonal therapies for spermatogenic disorders [Review]. Endocr J. 2017 Feb 27;64(2):123-131. doi: 10.1507/endocrj.EJ17-0001. Epub 2017 Jan 19. PMID: 28100869.
34. Esteves SC, Humaidan P. The role of luteinizing hormone activity in spermatogenesis: from physiology to clinical practice. Reprod Biol Endocrinol. 2025 Jan 13;23(Suppl 1):6. doi: 10.1186/s12958-024-01333-4. PMID: 39800700; PMCID: PMC11726975.
35. Ho CC, Tan HM. Treatment of the Hypogonadal Infertile Male-A Review. Sex Med Rev. 2013 May;1 (1):42-49. doi: 10.1002/smrj.4. Epub 2015 Oct 21. PMID: 27784559.
36. Casarini L, Crépieux P, Reiter E, Lazzaretti C, Paradiso E, Rochira V, Brigante G, Santi D, Simoni M. FSH for the Treatment of Male Infertility. Int J Mol Sci. 2020 Mar 25;21(7):2270. doi: 10.3390/ijms21 072270. PMID: 32218314; PMCID: PMC7177393.
37. Masterson TA, Turner D, Vo D, Blachman-Braun R, Best JC, Westfield G, Bryson N, Ramasamy R. The Effect of Longer-Acting vs Shorter-Acting Testosterone Therapy on Follicle Stimulating Hormone and Luteinizing Hormone. Sex Med Rev. 2021 Jan;9(1):143-148. doi: 10.1016/j.sxmr.2020.0 7.006. Epub 2020 Sep 8. PMID: 32912767.
38. Greenberg DR, Hudnall MT, Goyette BN, Lai JD, Hayon S, Bennett NE, Brannigan RE, Halpern JA. Assessing the Prevalence of Low Testosterone and Elevated Follicle Stimulating Hormone Among Men Presenting for Fertility Evaluation Without Oligospermia. Urology. 2023 Oct;180:130-134. doi: 10.1016/j.urology.2023.07.011. Epub 2023 Jul 22. PMID: 37482101.
39. Casarini L, Lispi M, Longobardi S, Milosa F, La Marca A, Tagliasacchi D, et al. LH and hCG action on the same receptor results in quantitatively and qualitatively different intracellular signalling. PLoS ONE. (2012) 7:e46682. doi: 10.1371/journal.pone.0 046682