Predictive Value Of Serum Inhibin B For Sperm Retrieval Outcomes In Non-obstructive Azoospermic Men

1.Objective:Intracytoplasmic sperm injection(ICSI)with spermatozoa recovered by testicular sperm extraction(TESE)has provided the possibility for the infertility men to reproduce,especially in severe oligozoospermic patients or azoospermic patients.The TESE procedure has been shown to be successful even in testes with only focal spermatogenesis.However,unsuccessful sperm recovery occurs in as many as 50%of non-obstructive azoospermic patients.A non-invasive marker predicting successful sperm recovery before TESE would be useful for evaluating azoospermic men.Serum inhibin B and follicle-stimulating hormone are the most valuable indicators.In this study,we evaluated the diagnostic accuracy to predict the spermatogenesis of non-obstructive azoospermic men in examination of serum inhibin B(INHB)and serum follicle stimulating hormone(FSH),alone or in combination.2.Methods:Quantitative examination of serum INHB,FSH,luteotropic hormone(LH),testosterone(T),seminal fructose,neutral-a glucosidase and testicular volume(calculated on unilateral side)were detected.We acquired testicular biopsies to confirm whether the sperm exist by testicular sperm extraction(TESE)and evaluated the testicular spermatogenic function by Johnsen score.We grouped the patients depending on their FSH levels and the outcomes of histological evaluation of testicular biopsies.All parameters were compared between the groups.The receiver operating characteristic curve was used to compare the diagnostic accuracy of these different indicators which were used to predict the spermatogenesis of non-obstructive azoospermic men,alone or in combination.3.Results:Testicular sperm was successfully retrieved in 137 of 291 patients(47.08%).The INHB levels were significantly higher in the sperm group(TESE+)than the non-sperm group(TESE-)(P<0.05).In all patients and the patients with normal FSH,the serum FSH levels were significantly higher in the non-sperm group than the sperm group(P<0.05).As the spermatogenetic damage was aggravating,the INHB levels were reducing gradually.According to the receiver operating characteristic curve(ROC curve)analysis,Predictive value of the INHB levels for outcomes of TESE was superior to FSH(P<0.05).4.Conclusions:By the large,predictive value of the INHB levels for outcomes of TESE was superior to FSH for the patients with FSH higher.INHB is the direct and effective serum marker in the evaluation of testicular spermatogenesis,and it is of great significance for patients to determine whether testicular biopsy should be performed or not.Due to the restrictions of surgical methods used to sperm retrieval,the applied value of serum INHB should be explored further.