International Urology and Nephrology

, Volume 38, Issue 3–4, pp 629–635 | Cite as

Can serum Inhibin B and FSH levels, testicular histology and volume predict the outcome of testicular sperm extraction in patients with non-obstructive azoospermia?

  • Lutfi Tunc
  • Mustafa Kırac
  • Serhat Gurocak
  • Aysegul Yucel
  • Bora Kupeli
  • Turgut Alkıbay
  • Ibrahim Bozkirli
Research Article
First Online:
Received:
Accepted:

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.

Keywords

Spermatogenesis Inhibin B Azoospermia Sperm extraction 
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References

  1. 1.
    Schlegel PN, Su L (1997) Physiological consequences of testicular sperm extraction. Human Reprod 12:1688–1692CrossRefGoogle Scholar
  2. 2.
    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 11:127–132Google Scholar
  3. 3.
    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 14:2020–2024Google Scholar
  4. 4.
    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 49:91–96PubMedCrossRefGoogle Scholar
  5. 5.
    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):289–294PubMedCrossRefGoogle Scholar
  6. 6.
    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 12:2422–2428CrossRefGoogle Scholar
  7. 7.
    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 13:1230–1234CrossRefGoogle Scholar
  8. 8.
    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):1195–1198PubMedCrossRefGoogle Scholar
  9. 9.
    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):1734–1738CrossRefGoogle Scholar
  10. 10.
    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 72:13–22PubMedCrossRefGoogle Scholar
  11. 11.
    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):971–976CrossRefGoogle Scholar
  12. 12.
    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 84:2496–2501CrossRefGoogle Scholar
  13. 13.
    Fisher LD, Van Belle G (1993) Biostatistics: a methodology for the health sciences. Wiley Science Paperback series, New York, pp 124–130Google Scholar
  14. 14.
    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 10:1457–1460Google Scholar
  15. 15.
    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):115–119Google Scholar
  16. 16.
    Adamopoulos DA (2000). Medical treatment of idiopathic oligozoospermia and male factor subfertility. Asian J Androl 2:25–32PubMedGoogle Scholar
  17. 17.
    Kolb BA, Stanczyk FZ, Sokol RZ (2000) Serum Inhibin B levels in males with gonadal dysfunction. Fertil Steril 74:234–238PubMedCrossRefGoogle Scholar
  18. 18.
    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 81:1321–1325PubMedCrossRefGoogle Scholar
  19. 19.
    Pierik FH, Vreeburg JTM, Stijnen T (1998) Serum Inhibin B as a marker of spermatogenesis. J Clin Endocrinol Metab 83:3110–3114PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media B.V. 2006

Authors and Affiliations

  • Lutfi Tunc
    • 1
  • Mustafa Kırac
    • 1
  • Serhat Gurocak
    • 1
  • Aysegul Yucel
    • 1
  • Bora Kupeli
    • 1
  • Turgut Alkıbay
    • 1
  • Ibrahim Bozkirli
    • 1
  1. 1.UrologyGazi universityAnkaraTurkey

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