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In this opinion article, we briefly analyze the pathophysiological evidences in favor of a more aggressive approach in planning future studies on pharmacological FSH use in male infertility, in analogy with the FSH use for multiple follicular growth in women undergoing ovarian stimulation for assisted reproduction. There is sufficient evidence that spermatogenesis does not run at its top in the primate and that some extra FSH can stimulate spermatogenesis over its baseline. Existing data suggest that the pharmacological regimens applied so far were insufficient, both in dosage and in duration, to elicit this response in about half of the patients. A paradigm change is needed now: We should move away from the classical, endocrinological approach, which simply applied the substitutive, therapeutic regimen used in hypogonadotropic hypogonadism, toward testing a \u2018testicular hyperstimulation\u2019 scheme for a time sufficient to cover more than only one spermatogenic cycle, a concept to be verified in an appropriately controlled, prospective, randomized clinical trial.<\/jats:p>","DOI":"10.1111\/andr.12746","type":"journal-article","created":{"date-parts":[[2019,12,24]],"date-time":"2019-12-24T09:14:34Z","timestamp":1577178874000},"page":"535-544","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":33,"title":["FSH treatment of male idiopathic infertility: Time for a paradigm change"],"prefix":"10.1111","volume":"8","author":[{"given":"Manuela","family":"Simoni","sequence":"first","affiliation":[{"name":"Unit of Endocrinology Department of Biomedical, Metabolic and Neural Sciences University of Modena and Reggio Emilia Modena Italy"},{"name":"Unit of Endocrinology Department of Medical Specialties Azienda Ospedaliero\u2010Universitaria of Modena Modena Italy"},{"name":"BIOS INRA CNRS IFCE Universit\u00e9 de Tours Nouzilly France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6607-7105","authenticated-orcid":false,"given":"Daniele","family":"Santi","sequence":"additional","affiliation":[{"name":"Unit of Endocrinology Department of Biomedical, Metabolic and Neural Sciences University of Modena and Reggio Emilia Modena Italy"},{"name":"Unit of Endocrinology Department of Medical Specialties Azienda Ospedaliero\u2010Universitaria of Modena Modena Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,1,8]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/andr.12502"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/andr.12673"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbadis.2012.02.008"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2018.00763"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1172\/JCI96794"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/j.1939-4640.1990.tb00153.x"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.2164\/jandrol.109.008391"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1530\/rep.0.1250769"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1210\/me.2014-1356"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1210\/jcem-65-6-1210"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1152\/physrev.00009.2002"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1210\/en.2003-1164"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1677\/JOE-10-0025"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1210\/endo.141.5.7456"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1038\/ng0297-201"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1038\/ng0297-205"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mce.2010.08.016"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejmg.2017.04.004"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1677\/joe.1.06634"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.semcdb.2016.06.018"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1210\/en.2008-0086"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40618-018-0843-y"},{"key":"e_1_2_10_24_1","first-page":"CD005071","article-title":"Al\u2010Inany HG. 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