Abstract
Introduction
In our study, we evaluated the diagnostic accuracy of serum follicle stimulating hormone (FSH), Inhibin B, testicular volumes and distribution of testicular sperm extraction (TESE) outcome according to the histological diagnosis in men with non-obstructive azoospermia.
Materials and methods
Between February 2001 and April 2002, 66 men presenting with infertility of at least 1 year were found to have non-obstructive azoospermia. Serum FSH and Inhibin B levels, testicular volumes and pathological analysis were reviewed retrospectively using medical records of these patients.
Results
Of 66 patients, 52 were enrolled into the study and sperm extraction was successful in 31 of 52 patients (59.6%). There was no statistically significant difference between the patients who had successful and unsuccessful TESE in terms of mean serum Inhibin B, FSH levels and testicular volumes (P > 0.05). The area under ROC analysis for serum Inhibin, serum FSH and testicular volume was 0.557, 0.523 and 0.479, respectively. For Inhibin B, the best cut-off value for discriminating between successful and failed TESE at 90% sensitivity was 6.25 with a very low level of specificity (14%) and diagnostic accuracy that was 53.8.
Conclusion
Besides the controversies about the direct marker role of serum Inhibin B in determination of spermatogenesis, it does not seem to give a clue about the prediction of sperm presence before TESE. Because of the conflicting results in the literature, the potential role of serum Inhibin B as a marker for prediction of sperm presence in testis is yet to be determined.
Similar content being viewed by others
References
Schlegel PN, Su L (1997) Physiological consequences of testicular sperm extraction. Human Reprod 12:1688–1692
Tournaye H, Liu J, Nagy PZ, Camus M, Goossens A, Silber S et al. (1996) Correlation between testicular histology and outcome after intracytoplasmic sperm injection using testicular sperm. Human Reprod 11:127–132
Ezeh UIO, Moore HDM, Cooke ID (1998) Correlation of testicular sperm extraction with morphological, biophysical and endocrine profiles in men with azoospermia due to primary gonadal failure. Human Reprod 14:2020–2024
Mulhall JP, Burgess CM, Cunningham D, Carson R, Harris D, Oates RD (1997) Presence of mature sperm in testicular parenchyma of men with non-obstructive azoospermia; prevalence and predictive factors. Urology 49:91–96
Bettella A, Ferlin A, Menegazzo M, Ferigo M, Tavolini IM, Bassi PF et al. (2005) Testicular fine needle aspiration as a diagnostic tool in non-obstructive azoospermia. Asian J Androl 7(3):289–294
Silber SJ, Nagy Z, Devroey P, Tournaye H, Van Steirteghem AC (1997) Distribution of spermatogenesis in the testicles of azoospermic men: the presence or absence of spermatids in the testes of men with germinal failure. Human Reprod 12:2422–2428
Jezek D, Knuth UA, Schulze W (1998) Successful testicular sperm extraction (TESE) in spite of high serum follicle stimulating hormone and azoospermia: correlation between testicular morphology, TESE results, semen analysis and serum hormone values in 103 infertile men. Human Reprod 13:1230–1234
Bohring C, Printzen IS, Weidner W, Krause W (2002) Serum levels of Inhibin B and follicle-stimulating hormone may predict successful sperm retrieval in men with azoospermia who are undergoing testicular sperm extraction. Fertil Steril 78(6):1195–1198
Ballesca J, Balasch J, Calfell JM, Alvarez R, Fabregues F, Osaba MJ et al. (2000) Serum Inhibin B determination is predictive of successful testicular sperm extraction in men with non-obstructive azoospermia. Human Reprod 15(8):1734–1738
Pineau C, Sahrpe RM, Saunders PTK, Gerard N, Jegou B (1990) Regulation of Sertoli cell inhibin production and of inhibin α-subunit mRNA levels by specific germ celltypes. Mol Cell Endocrinol 72:13–22
Vernaeve V, Tournaye H, Schiettecatte J, Verheyen G, Steirteghem AC, Devroey P (2002) Serum Inhibin B cannot predict testicular sperm retrieval in patients with non-obstructive azoospermia. Human Reprod 17(4):971–976
Von Eckardstein S, Simoni M, Bergmann M, Weinbauer GF, Gassner P, Schepers AG et al. (1999) Serum Inhibin B in combination with serum follicle-stimulating hormone (FSH) is a more sensitive marker than serum FSH alone for impaired spermatogenesis in men, but cannot predict the presence of sperm in testicular tissue samples. J Clin Endocrinol Metab 84:2496–2501
Fisher LD, Van Belle G (1993) Biostatistics: a methodology for the health sciences. Wiley Science Paperback series, New York, pp 124–130
Devroey P, Liu J, Nagy Z, Goossens A, Tournaye H, Camus M et al. (1995) Pregnancies after testicular sperm extraction and intracytoplasmic sperm injection in non-obstructive azoospermia. Human Reprod 10:1457–1460
Tournaye H, Camus M, Goossens A, Nagy Z, Silber S, Van Steirteghem AC et al. (1995) Recent concepts in the management of infertility because of non-obstructive azoospermia. Human Reprod 10(Suppl. 1):115–119
Adamopoulos DA (2000). Medical treatment of idiopathic oligozoospermia and male factor subfertility. Asian J Androl 2:25–32
Kolb BA, Stanczyk FZ, Sokol RZ (2000) Serum Inhibin B levels in males with gonadal dysfunction. Fertil Steril 74:234–238
Illingworth PJ, Groome NP, Bryd W (1996) Inhibin B: a likely candidate for the physiologically important form of Inhibin in man. J Clin Endocrinol Metab 81:1321–1325
Pierik FH, Vreeburg JTM, Stijnen T (1998) Serum Inhibin B as a marker of spermatogenesis. J Clin Endocrinol Metab 83:3110–3114
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Tunc, L., Kırac, M., Gurocak, S. et al. Can serum Inhibin B and FSH levels, testicular histology and volume predict the outcome of testicular sperm extraction in patients with non-obstructive azoospermia?. Int Urol Nephrol 38, 629–635 (2006). https://doi.org/10.1007/s11255-006-0095-1
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11255-006-0095-1