Abstract
ObjectiveThe reference range and potential value of inhibin B are still unclear and controversial. This study aimed to define the variation trend of inhibin B in healthy women with age and explore its value in the reflection of ovarian reserve.MethodsA total of 2524 healthy reproductive age women from eight medical institutes nationwide were recruited. The variation tendency of inhibin B with age was primarily established in the first group of 948 women and validated in another 605. We evaluated the relationship between inhibin B and classic ovarian reserve and function markers. The potency of inhibin B in predicting AFC <5-7 was also estimated and compared with FSH.ResultsThe nomogram showed that serum levels of inhibin B rapidly decreased after the age of 40. Inhibin B was positively correlated with AMH (R = 0.57, P < 0.001), AFC (R = 0.34, P < 0.001) and testosterone (R = 0.10, P = 0.002), and negatively correlated with FSH (R = -0.41, P < 0.001) and LH (R = -0.20, P < 0.001) and FSH/LH (R=-0.18, P < 0.001), while no correlation was found with PRL. Unexpectedly, Inhibin B (AUC = 0.74, P < 0.001 for the establishment population; AUC = 0.78, P < 0.001 for the validation population) had a slightly higher value than FSH (AUC = 0.71, P < 0.001 for the establishment population; AUC = 0.72, P < 0.001 for the validation population) in diagnosing AFC <5-7.ConclusionsFor healthy reproductive age women, the decline of inhibin B can reflect decreased ovarian reserve effectively, having a good consistency with AMH and AFC. More importantly, inhibin B had an advantage in predicting AFC <5-7 compared with FSH, which suggested the potential of inhibin B in predicting ovarian response. These results will be helpful to the clinical application of inhibin B in the evaluation of female ovarian reserve and the assessment of their reproductive capacity. Trial registration: http://clinicaltrials.gov; NCT02294500.
Highlights
Inhibin B, a heterodimeric glycoprotein that comprises an alpha subunit linked to a beta-B subunit, belongs to the superfamily of transforming growth factor-b
The findings of previous studies suggested that inhibin B may have certain clinical application potential in assessing the progress of ovarian aging, diagnosing premature ovarian failure (POF) or premature ovarian insufficiency (POI), evaluating the ovarian function of cancer survivors, and predicting assisted reproductive technology (ART) outcomes
antral follicle count (AFC), serum hormones, including inhibin B, follicle-stimulating hormone (FSH), LH, PRL, progesterone, E2, T, and anti-Mullerian hormone (AMH) were measurable in the majority of individuals (Table 1)
Summary
Inhibin B, a heterodimeric glycoprotein that comprises an alpha subunit linked to a beta-B subunit, belongs to the superfamily of transforming growth factor-b. The higher level of serum inhibin B of reproductive age women is one of the important factors to maintain a low level of serum FSH. With the increase of their age, both the quality and quantity of ovarian follicles decrease, the level of serum inhibin B decreases gradually, and the inhibitory effect on FSH will be weakened, which is one of the important reasons for the progressive increase of their serum FSH levels [1,2,3]. The findings of previous studies suggested that inhibin B may have certain clinical application potential in assessing the progress of ovarian aging, diagnosing premature ovarian failure (POF) or premature ovarian insufficiency (POI), evaluating the ovarian function of cancer survivors, and predicting assisted reproductive technology (ART) outcomes. Studies on the clinical application value of inhibin B were still had inconsistent findings, and the evidence was insufficient
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