Does the FSHB c.-211G>T polymorphism impact Sertoli cell number and the spermatogenic potential in infertile patients?

Andrology. 2020 Sep;8(5):1030-1037. doi: 10.1111/andr.12777. Epub 2020 Mar 20.


Background: A genetic variant within the FSHB gene can deviate FSH action on spermatogenesis. The c.-211G>T FSHB single nucleotide polymorphism impacts FSHB transcription and biosynthesis due to interference with the LHX3 transcription factor binding. This SNP was previously shown to be strongly associated with lowered testicular volume, reduced sperm counts, and decreased FSH levels in patients carrying one or two T-alleles.

Objective: To determine the impact of the SNP FSHB c.-211G>T on Sertoli cell (SC) number, Sertoli cell workload (SCWL) and thereby spermatogenic potential.

Material and methods: Testicular biopsies of 31 azoospermic, homozygous T patients (26 non-obstructive azoospermia (NOA), and five obstructive azoospermia (OA)) were matched to patients with GG genotype. Marker proteins for SC (SOX9), spermatogonia (MAGE A4), and round spermatids (CREM) were used for semi-automatical quantification by immunofluorescence. SCWL (number of germ cells served by one SC) was determined and an unbiased clustering on the patient groups performed.

Results: Quantification of SC number in NOA patients did not yield significant differences when stratified by FSHB genotype. SC numbers are also not significantly different between FSHB genotypes for the OA patient group and between NOA and OA groups. SCWL in the NOA patient cohort is significantly reduced when compared to the OA control patients; however, in neither group an effect of the genotype could be observed. The cluster analysis of the whole study cohort yielded two groups only, namely NOA and OA, and no clustering according to the FSHB genotype.

Discussion and conclusion: The FSHB c.-211G>T polymorphism does not affect SC numbers or SCWL, thereby in principle maintaining the spermatogenic potential. The previously observed clinical phenotype for the FSHB genotype might therefore be caused by a hypo-stimulated spermatogenesis and not due to a decreased SC number.

Keywords: FSHB c.-211 G>T polymorphism; azoospermia; sertoli cells.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Azoospermia / genetics
  • Cell Count
  • Cohort Studies
  • Follicle Stimulating Hormone, beta Subunit / genetics*
  • Humans
  • Infertility, Male / genetics*
  • Male
  • Polymorphism, Single Nucleotide*
  • Promoter Regions, Genetic
  • Sertoli Cells*
  • Sperm Count
  • Spermatogenesis / genetics*


  • Follicle Stimulating Hormone, beta Subunit

Supplementary concepts

  • Azoospermia, Nonobstructive