Serum and Seminal Plasma concentrations of Inhibin B and FSH: A Case-Control Comparison Study between Fertile and Infertile Males

Author's Name:

Adnan A. H. Al-Bdairi

C.A.B.O.G., (Gyn. & Obst.) Consultant, Teba IVF & Genetic Center, Babylon, Iraq.

Hayder Abdul-Amir. M. Al-Hindy

Ass. Prof., Dept. of Pharmacology and Toxicology, College of Pharmacy, University of Babylon, Iraq

Sallama Hamid Alkhudair

CABOG, FICOG, FIRM (Gyn. & Obst.) Consultant, Alzaitoon Specialized Fertility Center, Baghdad, Iraq

Khudhair Hussein Alkadhim

M.B.Ch.B., F.I.C.O.G.: Vice President, Iraqi Fertility Society, College of Medicine, University of Babylon, Iraq

Background: Infertility is among the most severe medical difficulties universally. Most of the men infertilities are resulted from testicular failure that cause absent spermatocytes from ejaculate (Azoospermia). Sperms can be retrieved invasively from the testicles by TESA or TESE. Inhibin B and FSH are known to be indicators of spermiogenesis and Sertoli cell activity and have been proposed to replace evaluating semen quality in clinical studies. Objectives: To inspect the potential variations between the values of seminal plasma and serum inhibin B and compare their levels between fertile and infertile males and evaluate their predictability for positive TESE outcomes.  Methodology: This study was case-control and included 50 fertile males and 50 azoospermic subjects, who presented with the primary complaint of infertility. All applicants submitted to complete medical history, physical examination, and biochemical assays for Testosterone, FSH, LH, Prolactin, and Inhibin-B in the plasma and semen and were referred for TESE. Statistical study was completed by SPSS. ROC curve analyses were tested for sensitivity and specificity of serum and seminal inhibin to predict positive TESE results. Results: The ages of participants ranged from 32.0 to 39.0 years with a history of infertility ranging from 4.0 to 7.0 years. The incidence of diabetes and hypertension was very low. The mean levels of seminal and serum inhibin B measures were higher among fertile subjects significantly (0.001) compared to azoospermic patients. Significant differences in the means of serum inhibin B (p-0.019), but not seminal inhibin B (p-0.6) were detected according to TESE results. Inhibin B and FSH revealed a nonsignificant correlation in serum and seminal plasma of both azoospermic and fertile groups (p>0.05). Serum inhibin B showed a better sensitivity, specificity, accuracy, and predictability for positive TESE results as follows: 73.7%, 67.7%, 70.0%, and ≥41.25, respectively compared to seminal inhibin B: 73.7%, 29.0%, 46.0%, and ≥ 13.60 one-to-one. Conclusion: Both seminal plasma and serum inhibin B mean levels were significantly higher among fertile compared to azoospermic male groups. Inhibin B and FSH revealed a non-significant correlation in serum and seminal plasma of both azoospermic and fertile groups. There were significant differences in the means of serum inhibin B, but not seminal inhibin B, according to TESE results. This study does not support the assumption that in vivo seminal and serum inhibin B can be dedicated as a substitute in the investigations of infertile men.

Keywords: Non-obstructive Azoospermia (NOA), Seminal, Plasma, Inhibin B, FSH, Infertility, Testicular sperm extraction or (TESE), Sperm retrieval ,
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