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Turkey Medicals member and JCI hospital department Urology Specialist Prof. Dr. said, The first test performed in couples where pregnancy does not occur despite the fact that a certain period of time has passed and they want it is a sperm test. If a dead or live sperm cell has never been found, or if it turns out to be very few and of good quality, measurement of FSH and testosterone in the blood is required as a second step. The FSH hormone result can be a little confusing. So, what does the hormone FSH stand for?

The explicit name of the hormone FSH is follicle-stimulating hormone. Considering that it is related to the follicles in which egg cells develop in a woman, this name was initially given, but later its relationship with sperm production in a man was understood. The hormone FSH is secreted in the brain from the pituitary gland. Then it gets into the blood and reaches the testicle. Jul is the main source of sperm in the testicle to provide the nutrients it needs. Just as a flower needs water and sunlight to open, the hormone FSH is necessary for the maturation of sperm cells in the testicles. For this reason, while it is low in pre-adolescent children, it begins to rise to its normal levels by the time they reach reproductive age. If it is lower than normal in an adult man, sperm production is again disrupted, and even the course towards azoospermia begins. In addition to the fact that FSH is low, another importance is the cases when it is excessively elevated. This, in turn, gives us important information about sperm production. That is why the interpretation of the hormone FSH is a little confusing.

FSH from the brain has 3 targets in the testis; Sertoli cells, Leydig cells, and sperm stem cells. Each of these cells has a separate significance. Sertoli cells are the main source of nutrients for spermatozoa and act as a support for them until they mature by embracing spermatozoa. For this reason, it is extremely important for a man’s reproductive function to be healthy. In men with low levels of the FSH hormone, when this support is stopped, sperm production is also disrupted, first it decreases in number, and as a result, it goes to azoospermia.

Another important development in recent years has been that FSH directly reaches sperm stem cells and contributes to their maturation. The presence of a group of stem cells in the testicle, which were overlooked in normal microscopic examinations because they were too small, was revealed. In these cells, there are receptors that will meet the hormone FSH, that is, some kind of gates. For this reason, FSH hormone therapy can be expected to benefit the testicles, which we call Sertoli cell only and shows the most advanced form of azoospermia.

Another group of cells affected by the hormone FSH in the testicle are Leydig cells. They are responsible for the production of testosterone, and if they do not work enough, the testosterone level drops. Maintaining a high amount of testosterone for the testicle is very important. 100 times more testosterone is needed than is measured in the blood. Therefore, the FSH hormone is also necessary for healthy sperm production through testosterone.

As can be understood from the above, one of the causes of impaired sperm production and azoospermia may be a low level of the hormone FSH in the blood. If treated properly, it is possible to restore production and even ensure normal sperm output. But these treatments can sometimes take months. Even if there is no sperm output, at least it increases the chances of finding sperm in the testicles with TESE.

Another importance of FSH is that it sounds very high than usual in measurements. As sperm production in the testicle deteriorates, FSH in the blood also increases in parallel with this. We also get an idea of the severity of the disruption in the testicles by looking at the FSH level. But a high FSH should not necessarily mean that sperm production in the testicles will be stopped, because we see that sperm can be found in the testicle in TESE surgery, no matter how high it is. A high level of FSH is an indication that Sertoli cells are not functioning and sperm production is impaired. Because the hormone we call inhibin-B, which comes out of the Sertoli cells, balances the production of FSH by reaching the brain. If sertoli cells do not work enough, inhibin-B also decreases, and the brain secretes more FSH. As a result, we also find high FSH in the assays. An indicator of whether the treatments performed on the testicles are effective is that the FSH hormone, which has been increased, is gradually decreasing. In some cases of azoospermia, gonadotropin-type hormones are used that stimulate the production of testosterone that has fallen into the testicle. The effectiveness of such treatment can be traced in the fact that the level of FSH in the blood approaches normal.

On the other hand, we can’t say that FSH hormones always give precise ideas. The genetic structure, which differs from person to person, and the extremely complex communication mechanisms in the testicles significantly affect its sensitivity. Nevertheless, our greatest helper about the state of sperm production is the hormone FSH. FSH hormone is one of our most important helpers in the treatment of sperm DNA damage, even in order to support existing sperm production by replacing it when it is low, and if it is normal, even in the treatment of sperm DNA damage. But let’s note right away, hormone therapy is like a double-edged knife, overdoing it can have the opposite effect, while sometimes it can also have serious side effects. Therefore, it must be used under the supervision of a doctor in Turkey.


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President of Organ Transplant Center at MedicalPark Hospital Antalya

Turkey's world-renowned organ transplant specialist. Dr. Demirbaş has 104 international publications and 102 national publications.

Physician's Resume:

Born on August 7, 1963 in Çorum, Prof. Dr. Alper Demirbaş has been continuing his work as the President of MedicalPark Antalya Hospital Organ Transplantation Center since 2008.

Prof. who performed the first tissue incompatible kidney transplant in Turkey, the first blood type incompatible kidney transplant, the first kidney-pancreas transplant program and the first cadaveric donor and live donor liver transplant in Antalya. Dr. As of August 2016, Alper Demirbaş has performed 4900 kidney transplants, 500 liver transplants and 95 pancreas transplants.

In addition to being the chairman of 6 national congresses, he has also been an invited speaker at 12 international and 65 national scientific congresses. Dr. Alper Demirbaş was married and the father of 1 girl and 1 boy.


Eczacibasi Medical Award of 2002, Akdeniz University Service Award of 2005, Izder Medical Man of the Year Award of 2006, BÖHAK Medical Man of the Year Award of 2007, Sabah Mediterranean Newspaper Scientist of the Year Award of 2007, ANTIKAD Scientist of the Year Award of 2009, Social Ethics Association Award of 2010, Işık University Medical Man of the Year Award of 2015, VTV Antalya's Brand Value Award of 2015.


Doctor of Medicine Degree Hacettepe University Faculty of Medicine Ankara, General Surgeon Ministry of Health Turkey EKFMG (0-477-343-8), University of Miami School of Medicine Member of Multiple Organ Transplant, ASTS Multiorgan Transplant Scholarship. Lecturer at Kyoto University. Lecturer at University of Essen, Research assistant at the University of Cambridge .

Professional Members:

American Society of Transplant Surgeons, American Transplantation Society Nominated, Middle East and Southern Africa Council Transplantation Society 2007, International Liver Transplantation Association, Turkish Transplantation Association, Turkish Society of Surgery, Turkish Hepatobiliary Surgery Association.


Our website contents consist of articles approved by our Web and Medical Editorial Board with the contributions of our physicians. Our contents are prepared only for informational purposes for public benefit. Be sure to consult your doctor for diagnosis and treatment.
Medically Reviewed by Professor Doctor Alper Demirbaş
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