Serum inhibin-B Research Articles

Reference intervals of inhibin B in Chinese children on chemiluminescence analyzer

Inhibin B (INHB) is an emerging biomarker of sexual function diseases, but its clinical use in children is hindered due to the lacking reference intervals (RIs) based on age and sex. A total of 622 healthy Chinese children including 48.6% females and 51.4% males were included and serum INHB and six conventional sex hormones were measured. INHB was partitioned by four predetermined age groups (< 1 year, 1–5 years, 5–10 years, 10–18 years) and the corresponding RIs were determined with quantile. The effect of age on INHB was assessed using five models including linear, quadratic, cubic, S, and logarithmic. Spearman correlation was used to examine the associations between INHB and sex hormones. Compared to the boys, girls had lower median concentrations and variability in INHB across all four age groups. The optimal models for the effect of age on INHB were cubic (R2 = 0.440 for boys and R2 = 0.198 for girls). The median INHB concentrations in the youngest and oldest age groups for girls were higher than the two intermediate age groups and in the youngest age group for boys were higher than other age groups (all P ≤ 0.001). Spearman’s correlation analysis showed the sex-dependent associations between INHB and conventional sex hormones (e.g. a positive association with PRL in boys). INHB level is influenced by age and sex, and our results provide specific RIs to facilitate screening sexual function diseases in Chinese children.

Inhibin B and antiMüllerian hormone as surrogate markers of fertility in male and female Crohn's disease patients: a case-control study.

Several studies suggest that women with Crohn disease (CD) have reduced fertility due to decreased ovarian reserve, among other causes. On the other hand, male CD patients could have difficulties conceiving. The present study aimed to test the effect of CD on both male and female fertility potential, Sertoli cell function and ovarian reserve, assessed by inhibin-B (IB) plus IB:FSH ratio (IFR) and antiMüllerian hormone (AMH), respectively. Sexual dysfunction (SD) was studied as secondary endpoint. We performed a cross-sectional, case-control study. Serum IB levels plus IFR were measured in 58 men with CD and compared to 25 age-matched healthy controls (HC). Serum AMH levels were measured in 50 women with CD and in 30 HC matched by age. SD was assessed by means of the International Index of Erectile Function (IIFE-15) in males and the Index of Female Sexual Function (IFSF) in women. A total of 108 CD patients and 55 HC were included. IB serum levels were significantly lower in CD men than in HC (177 ± 58 vs. 234 ± 75 pg./mL, p = 0.001). IFR was also decreased in CD patients compared to HC (58.27 ± 59.5 vs. 91.35 ± 60.04, p = 0.014). Women with CD > 30 years had lower serum AMH levels compared to HC (1.15 ± 0.74 vs. 2.14 ± 1.68 ng/mL, p = 0.033). In addition, CD women >30 years presented a serum AMH < 2 ng/mL more frequently than HC (90% vs. 40%, p = 0.004). The prevalence of SD was significantly higher among both male and female CD patients compared to HC, without association to fertility potential. Age was the only predictor of low ovarian reserve. Testicular Sertoli cell function assessed through serum IB levels and IFR is decreased in CD male patients compared to HC, regardless of age. Age > 30 years is the single independent predictor of reduced ovarian reserve in women with CD. These results should be confirmed in further studies in order to properly counsel patients with CD and desire for offspring.

Female patients with systemic lupus erythematosus (SLE)-associated antiphospholipid syndrome (APS) have a lower ovarian reserve than either primary APS or SLE patients

Abstract Objectives To evaluate the ovarian reserve (OR) in women with antiphospholipid syndrome (APS), systemic lupus erythematosus (SLE), especially SLE-associated APS, and to determine the association between OR and clinical and laboratory parameters. Methods We compared the antral follicle count (AFC), anticardiolipin antibody, and anti-Müllerian hormone (AMH), inhibin B (INHB), antiphospholipid (aPL) antibody, follicle-stimulating hormone (FSH), progesterone (P), testosterone (T), and estradiol (E2) among patients with primary APS (PAPS), SLE-APS, and SLE who were treated at Jinhua Central Hospital between 2017 and 2020. We conducted correlations and logistic regression analyses to identify the risk factors of OR failure in women with APS. Results Serum AMH were positively correlated with AFC and INHB in APS patients, and low AMH was independent risk factor for OR decline in APS patients. The ROC curve showed a high accuracy for AMH in the prediction of OR failure. Compared to healthy subjects (HS), patients with PAPS, SLE-APS, and SLE exhibited lower serum AMH, AFC, INHB, and E2 levels and higher FSH and levels (p&lt;0.05). Of all the patients, those with SLE-APS manifested the lowest serum AMH, AFC, INHB, and E2 levels and the highest FSH levels (p&lt;0.05). Conclusions APS and SLE patients showed lower indications of OR, including AFC and AMH, compared to HS. SLE-APS patients also appeared to have a lower OR than either SLE or PAPS patients.

Mediation of association between semen microcystin exposure and semen quality by sex hormones in Chinese men

Numerous studies have shown microcystins (MCs) inducing male reproductive toxicity, but the underlying mechanisms in humans are unclear. Therefore, this study aimed to evaluate the mediating role of serum sex hormones in the association between MC exposure and semen quality. In this study, we measured the levels of semen MCs and serum sex hormones in Chinese men [sample 1 (n = 649); sample 2 (n = 924)]. The results showed that there was a non-significant dose-dependent relationship between semen MCs and semen volume reduction (p for trend = 0.079) in sample 1, and semen MCs were significantly negatively associated with total motility, progressive motility, curvilinear velocity, mean angular displacement and acrosome integrity (p < 0.05) in sample 2. We also found that semen MCs were significantly positively associated with serum follicle stimulating hormone (FSH) (β = 0.151; 95% CI: 0.065, 0.236), but negatively associated with serum inhibin B (INHB) (β = −0.605; 95% CI: −0.944, −0.265), and these linear associations were confirmed in restricted cubic spline (RCS) models (all pnon-linearity > 0.1). Furthermore, mediation analysis revealed that serum INHB mediated 19.86% of the adverse effect of MC exposure on acrosome integrity. In conclusion, this study reveals the mediating roles of serum sex hormones in the relationship between MC exposure and decreased semen quality in men.

The Inhibin-B Level at Orchidopexy and Follow-up of 280 Boys With Non-syndromic Unilateral Cryptorchid Testes

PurposeAn impaired germ cell number per tubular cross-section (G/T) at orchidopexy indicates a high risk of infertility. A recent study in boys with bilateral cryptorchidism showed a very high predictive value for a low serum inhibin-B level, indicating bilateral impaired G/T. Several other studies have shown a fairly strong correlation between inhibin-B and G/T. We aimed to evaluate if inhibin-B levels at orchidopexy improved at follow-up in boys with unilateral cryptorchidism. MethodsWe included 280 boys with unilateral non-syndromic cryptorchidism at the median age of 1 year (4 months-9 years) who underwent orchidopexy. They were evaluated for serum FSH, LH and inhibin-B levels at surgery and at follow-up (median 16 months later), including multiple of the median (MoM) estimations of inhibin-B due to the age dependency of normal levels. ResultsThe inhibin-B MoM score improved significantly at follow-up. At orchidopexy, 59 (21%) boys had inhibin-B levels below the normal 2.5-percentile indicating impaired G/T bilaterally. At follow-up, 36% of the boys still had low inhibin-B. At orchidopexy, 221 (79%) boys had inhibin-B levels above normal 2.5-percentile and only 5% had low inhibin-B levels at follow-up. The risk of low inhibin-B levels at follow-up was significantly different between the two groups (p < 0.0001). At follow-up, totally, 32 (11%) boys had low inhibin-B levels, hereof only 3 patients with increased FSH. ConclusionsOrchidopexy benefits the fertility potential. About 10% of boys with unilateral non-syndromic cryptorchidism may have a bilateral testicular disease reducing their fertility potential. Insufficient gonadotropin stimulation may possibly be the cause.

Scrotal insulation impairs spermatogenesis but not Sertoli cell endocrine function

Testicular thermal insult is detrimental to spermatogenesis and a common cause of testicular degeneration. Changes in semen quality after scrotal insulation are well understood but its effects on Sertoli cell function is still not fully characterized. Isoform-specific assays have provided opportunities for analysis of inhibin-A and B. Recent studies in stallions have shown inhibin-B decreases after treatment with a GnRH receptor antagonist but returns with spermatogenesis after treatment stops, suggesting it may be a useful biomarker for testicular damage and recovery (Ball.et.al. Theriogenology; 2019; 213:108-115). The hypothesis of the present study was that serum inhibin-B correlates positively with sperm parameters after scrotal insulation decreasing as sperm motility and production decline. Stallions were assigned to a untreated control (n=4) and treated group (n=5) that was submitted to scrotal insulation for 1 hour in the morning and 1 hour in the afternoon, for two consecutive days, using a thermal blanket surrounding the scrotum. The intratesticular temperature was measured immediately after the blanket was removed and increased ∼10°C during the insulation period. Semen was collected twice weekly, but semen and serum samples were evaluated weekly for 98 days after treatment. Testicular response was assessed by determination of the concentrations of testosterone and estrone sulphate (interstitial compartment) and inhibin-B (tubular compartment), respectively. Spermkinetics were analyzed by CASA (IVOS Version 12 Hamilton Thorne Research, MA, USA), sperm concentration by Neubauer hemocytometer (Optik Labor®, Lancing, England), serum concentrations of inhibin- B and estrone sulfate were determined by ELISA and testosterone by RIA. Data were analyzed by ANOVA for repeated measures. Sperm motility and total sperm number decreased from day 4 to 67 (P<0.05) and sperm abnormalities increased from day 17 and did not recover until the end of our evaluation (day 98). Testosterone concentrations declined acutely. A significantly reduction in circulating testosterone concentrations occurred at 4, 9 and 37 days after onset of scrotal insulation, which is probably the result of Leydig cell impairment. However, no changes in inhibin-B or estrone sulfate were seen in response to treatment (n.s.). In summary, thermal insult appears to affect germ cells, and Leydig cell but not Sertoli cell function and, consequently, does not disturb inhibin-B synthesis. It has to be concluded that inhibin-B is no reliable biomarker for testicular damage and recovery from thermal insults. Acknowledgements: Authors are grateful to São Paulo Research Foundation (FAPESP, grant #2019/01119-8 and #2022/03405-0), the John P. Hughes Endowment and the Clinical Endocrinology Laboratory, University of California-Davis.

Effects of electroacupuncture on pregnancy outcome in poor ovarian response patients of kidney essence deficiency and undergoing in vitro fertilization-embryo transfer

To observe the effects of electroacupuncture (EA) on ovarian reaction, egg and embryo quality, as well as pregnancy rate in poor ovarian response (POR) patients of kidney essence deficiency and undergoing in vitro fertilization-embryo transfer (IVF-ET). Ninety-six patients who met the inclusion criteria were randomly divided into an EA group and a control group, with 48 cases in each group. Before IVF-ET, the patients in the EA group received EA, once daily, 2 or 3 treatments a week for 12 weeks. Before and after the treatment, traditional Chinese medicine (TCM) syndrome score and clinical pregnancy rate were assessed in two groups. The concentrations of serum follicle-stimulating hormone (FSH), luteinsing hormone, estradiol, progesterone and anti-mullerian hormone were detected by chemiluminescence; the contents of serum insulin-like growth factor-1, serum inhibin B (INHB) and Kisspeptin in follicular fluid were determined by enzyme linked immunosorbent assay (ELISA); the antral follicle counting (AFC) was detected by color Doppler ultrasonography; and the egg and embryo conditions were observed under microscope. Fourteen days after embryo transfer, the positive rate of serum hemchoriconic gonadotropin (HCG) and clinical pregnancy rate were calculated. After the treatment, the TCM syndrome score and level of serum FSH were reduced (P<0.05); the INHB in serum and AFC were increased (P<0.05) when compared with those before the treatment in the EA group. After the treatment, in comparison with the control group, the TCM syndrome score and level of serum FSH were lower (P<0.05); and the contents of serum INHB, AFC, the numbers of MⅡ eggs and high-quality embryos, as well as serum HCG positive rate were all increased (P<0.05) in the EA group. EA can relieve the clinical symptoms of TCM in POR patients of kidney essence deficiency and undergoing IVF-ET, increase the ovarian reserve, reduce the serum FSH level, and improve the content of serum INHB, and the quality of eggs and embryos. This therapy tends to improve the clinical pregnancy rate and clinical pregnancy outcome.

Serum kisspeptin, neurokinin Band inhibin B levels can be used as alternative parameters to distinguish idiopathic CPP from premature thelarche in the early stages of puberty.

There is controversial results about serum kisspeptin, neurokinin-B (NKB), anti-Müllerian hormone (AMH)and inhibin B (INHB) levels in girls with central precocious puberty (CPP). Aim of this study is to evaluate serum levels of these four peptides in patients presented with early pubertal signs, and to evaluate their diagnostic validity in the diagnosis of CPP. Cross-sectional study. Study included 99 girls (51 CPP, 48 premature thelarche [PT]) whose breast development started before 8 years and 42 age-matched healthy prepubertal girls. Clinical findings, antropometric measurements, laboratory and radiological findings were recorded. Gonadotropin-releasing hormone (GnRH) stimulation test was performed in all cases with early breast development. Kisspeptin, NKB, INHBand AMH levels were measured in fasting serum samples using enzyme-linked immunosorbent assay method. There was no statistically significant difference between mean ages of girls with CPP (7.1 ± 1.2 years), PT (7.2 ± 1.3 years)and prepubertal controls (7.0 ± 1.0 years). Serum kisspeptin, NKBand INHB levels were higher in CPP group compared to PT and control groups, while serum AMH level was lower in CPP group. Serum kisspeptin, NKB, and INHB were all positively correlated with bone age (BA) advancement, and peak luteinizing hormonein GnRH test. Multiple stepwise regression analysis revealed that the most important factors used to differentiate CPP from PT were advanced BA, serum kisspeptin, NKB and INHB levels (AUC: 0.819, p < .001). We, firstshowed in the same patients' group that serum kisspeptin, NKB and INHB were higher in patients with CPP and can be used as alternative parameters to distinguish CPP from PT.

Evaluation of Serum AMH, INHB Combined with Basic FSH on Ovarian Reserve Function after Laparoscopic Ovarian Endometriosis Cystectomy.

ObjectiveThe value of serum AMH, INHB, and bFSH levels in assessing postoperative ovarian reserve function was analyzed by measuring serum anti-Mullerian hormone (AMH), inhibin B (INHB), and basal follicle-stimulating hormone (bFSH) levels in patients after laparoscopic cystectomy for endometrioma.MethodsFrom June 2019 to December 2021, 124 patients underwent laparoscopic cystectomy for endometrioma in our hospital were selected, and the serum AMH, INHB, bFSH level, antral follicle count (AFC) of all patients before and after operation were detected and compared. According to the results of postoperative testing, all the patients were divided into normal group (n = 86), diminished ovarian reserve (DOR) group (n = 27), and premature ovarian failure (POF) group (n = 11). Pearson correlation model and subject operating characteristic curve (ROC) were used to analyze the correlation and diagnostic value of serum AMH, INHB and bFSH levels with postoperative ovarian reserve function, respectively.ResultsAfter operation, the levels of serum AMH, INHB and AFC in the DOR group and POF group decreased compared with those before the operation, and the serum bFSH levels increased (p < 0.05). After operation, the levels of serum AMH, INHB and AFC in DOR group and POF group were lower than those in normal group,and the serum bFSH levels were higher than the normal group; the levels of serum AMH, INHB and AFC in POF group were lower than those in DOR group, and the serum bFSH levels were higher than the DOR group (p < 0.05). Pearson analysis showed that serum AMH and INHB levels were negatively correlated with bFSH, and positively correlated with the number of AFC, the serum bFSH level was negatively correlated with the number of AFC (p < 0.05). The diagnostic values of serum AMH, bFSH, INHB and the combination of the three tests for postoperative abnormal ovarian reserve function were 0.866 (95% CI, 0.801–0.923), 0.810 (95% CI, 0.730–0.890), 0.774 (95% CI, 0.687–0.860) and 0.940 (95% CI, 0.900–0.981), respectively.ConclusionSerum AMH and INHB levels decreased and bFSH levels increased in patients after laparoscopic cystectomy for endometrioma, both of which were closely related to postoperative ovarian reserve function, and both could evaluate ovarian reserve function after ovarian cyst debulking, and the combined test could significantly improve the detection rate.

Association between intake of soft drinks and testicular function in young men

Is intake of sugar-sweetened beverages (SSB) or artificially sweetened beverages (ASB) associated with testicular function in young men? Among young men unaware of their semen quality and reproductive hormone levels, intake of SSBs was associated with lower sperm concentration, lower total sperm count, and a lower ratio of serum inhibin-B/FSH. SSBs may adversely impact testicular function, but results are not consistent across studies. Moreover, the associations of ASB, energy-drinks or fruit juices with testicular function are unclear. Young healthy men and unselected for fertility status men enrolled in a cross-sectional study between 2008 and 2017. A total of 2935 young (median age: 19 years) men enrolled in the study. Intake of SSBs, ASBs, fruit juices, and energy-drinks was assessed with a validated food frequency questionnaire. Testicular function was assessed through conventional semen quality parameters (semen volume, sperm concentration, total count, motility and morphology), testicular volume assessed with ultrasound, and serum reproductive hormone concentrations (total testosterone, free testosterone, E2, inhibin-B, LH, FSH, sex hormone-binding globulin) were measured. In multivariable-adjusted analyses, men in the highest category of SSB intake (median: 1.1 servings (∼220 ml)/day) had a 13.2 million/ml lower median sperm concentration (95% CI: -21.0, -5.5) than non-consumers. A similar pattern was observed with total sperm count (-28 million (95% CI: -48, -9)), serum inhibin-B (-12 pg/ml (95% CI: -21, -4)), and inhibin-B/FSH ratio (-9 (95% CI: -18, 0)). The adjusted median difference in sperm concentration and inhibin-B associated with increasing SSB intake by 1 serving (∼200ml)/day at the expense of water was -3.4 million sperm/ml (95% CI: -5.8, -1.0) and -7 pg/ml (95% CI: -11, -3), respectively. Inferring causality is limited owing to the cross-sectional design. We adjusted for a number of potential confounders but cannot exclude that unmeasured lifestyle and behavior associated with soft drink intake is associated with testicular function in these young men. In the largest study to date, intake of SSBs was associated with lower sperm concentration, total sperm count, and serum inhibin-B/FSH ratio, consistent with a direct suppressive effect of SSB intake on testicular function among otherwise healthy men, potentially affecting fertility. However, the observed association between higher SSB intake and lower semen quality does not necessarily imply a decrease in fertility. Supported by research from the Danish Council for Strategic Research (2101-08-0058), Independent Research Fund Denmark (8020-00218B), European Union (212844), the Kirsten and Freddy Johansen's Foundation (95-103-72087), the Research Fund of the Capital Region of Denmark (A6176), and the NIH (P30DK046200). The authors report no conflict of interest. N/A.

Gonadotropins for testicular descent in cryptorchid congenital hypogonadotropic hypogonadism males beyond infancy.

To study the effect of combined gonadotropin therapy (CGT) on testicular descent±spermatogenesis in congenital hypogonadotropic hypogonadism (CHH) patients with cryptorchidism beyond infancy. This retrospective cohort study included CHH patients with cryptorchidism [bilateral (n=5) or unilateral (n=1)] treated with CGT for testicular descent±pubertal induction. All participants were treated with CGT [human menopausal gonadotropin (hMG) and human chorionic gonadotropin (hCG)] with hMG pretreatment in three and monitored for changes in testicular volume (TV), serum total testosterone (T), serum inhibin-B, and sperm concentration. Complete testicular descent to the scrotal position was achieved in 5/6 patients (10/11 testes) after 4.7±1.6months of treatment. There was 44±18%, 97.5% (IQR: 44-195), 10-fold (IQR: 3-19.6), and two-fold (IQR: 1.7-9.3) increase in stretched penile length, ultrasound measured TV, T level, and serum inhibin-B from baseline, respectively. In two pediatric cases, testicular descent occurred with isolated hMG therapy. At the last follow up (median: 23.5, IQR: 10.5-38.7months), all the descended testes remained in scrotal position. In four pubertal/postpubertal age patients, continuous CGT (18-60months) yielded T and inhibin-B levels of 16.64±1.46nmol/l and 106±32.6pg/mL, respectively. All the three patients with available semen analysis had sperm concentration of≥5 million/mL and one of them achieved paternity. A trial of CGT before orchiopexy may be considered in CHH males with cryptorchidism even beyond the narrow age-window of infancy. CGT may also have beneficial effects on future spermatogenesis and fertility outcomes in these patients.

RANKL regulates male reproductive function

Infertile men have few treatment options. Here, we demonstrate that the transmembrane receptor activator of NF-kB ligand (RANKL) signaling system is active in mouse and human testis. RANKL is highly expressed in Sertoli cells and signals through RANK, expressed in most germ cells, whereas the RANKL-inhibitor osteoprotegerin (OPG) is expressed in germ and peritubular cells. OPG treatment increases wild-type mouse sperm counts, and mice with global or Sertoli-specific genetic suppression of Rankl have increased male fertility and sperm counts. Moreover, RANKL levels in seminal fluid are high and distinguishes normal from infertile men with higher specificity than total sperm count. In infertile men, one dose of Denosumab decreases RANKL seminal fluid concentration and increases serum Inhibin-B and anti-Müllerian-hormone levels, but semen quality only in a subgroup. This translational study suggests that RANKL is a regulator of male reproductive function, however, predictive biomarkers for treatment-outcome requires further investigation in placebo-controlled studies.

Serum INHB levels and ACE gene I/D polymorphism with increased risk for unexplained infertility.

Angiotensin converting enzyme (ACE) has a significant role in the angiogenesis of ovarian endothelium and the resumption of meiosis and folicular growth. However, there is no any study concerning ACE polymorphism and unexplained infertility (UI). The main aim of this study is that both identify ACE polymorphism and measure the serum ACE, anti-Mullerian hormone (AMH) and inhibin-B (INHB) levels in UI patients and controls in Turkish population. Forty-seven UI patients and 41 controls were involved in this study. To determine the ACE polymorphisms, DNA isolation and PCR were performed. Then, serum ACE, AMH and INHB levels were measured spectrophotometrically. Patients with UI had significantly higher serum INHB levels compared with controls (P < 0.05). Serum ACE levels were decreased, compared to controls; however, the decrease was not significant. Serum AMH levels did not significantly differ from controls. When the relationship was analysed between ACE insertion/deletion (I/D) polymorphism and infertility risk, and ID genotype was chosen as reference, it was found to be 2.33 times more risk of UI than the women have DD genotype [DD versus ID: odds ratio = 2.33, 95% confidence interval (0.88-6.19); P = 0.086]. This finding indicates that DD genotype may be high risk for UI. Further studies are warranted to confirm this finding, especially with a larger population.

Serum inhibin B for differentiating between congenital hypogonadotropic hypogonadism and constitutional delay of growth and puberty: a systematic review and meta-analysis

PurposeThe distinction between congenital hypogonadotropic hypogonadism (CHH) and constitutional delay of growth and puberty (CDGP) in patients with delayed puberty is difficult to distinguish, but important for timely treatment. The aim of this study is to perform a systematic review and meta-analysis to determine the diagnostic performance of serum inhibin B (INHB) levels for differentiating CHH and CDGP.MethodsPubMed, EMBASE, and Cochrane Library databases were systematically searched from the date of database inception to November 10, 2019 for studies examining the use of serum INHB to discriminate between CHH and CDGP. Pooled odds ratios (OR), sensitivity, specificity, and 95% confidence intervals (CI) were calculated. The Quality Assessment of Diagnostic Studies-2 (QUADAS-2) was used to assess the quality of the included studies. Sub-analyses were performed including that based on testicular volume (TV) and study design.ResultsSeven studies, comprising of 349 patients (96 CHH and 253 CDGP), were included in the meta-analysis. For differentiating between CHH and CDGP, INHB level exhibited good diagnostic accuracy with a pooled sensitivity of 92% (95% confidence interval [CI]: 0.86–0.96, I2 = 0.4%, p = 0.4343), specificity of 92% (95% CI: 0.88–0.94, I2 = 68.1%, p = 0.0009), and pooled area under the receiver operating characteristic curve (AUC) of 0.9619. The cut-off values of INHB for boys were 56, 66, 80, 96, 94.7, 111, and 113 pg/ml (assay method standardized to Gen II ELISA). Sub-analyses showed that testicular volume and study design could be a source of statistically significant heterogeneity in specificity. In boys with a testicular volume of ≤3 ml, INHB performed well with a sensitivity of 92%, specificity of 98%, and AUC of 0.9956.ConclusionINHB exhibits excellent diagnostic efficiency in distinguishing CHH from CDGP, especially in boys with severe puberty deficiency (TV ≤ 3 ml).

The impact of early and successful orchidopexy on hormonal follow-up for 208 boys with bilateral non-syndromic cryptorchidism.

Inhibin-B is produced by Sertoli cells and decreased values might be associated with impaired fertility potential. The aim of the study was to evaluate the impact of bilateral orchidopexy on serum inhibin-B and follicle-stimulating hormone (FSH). A cohort study including 208 bilateral cryptorchid boys (median age: 1.7year) was evaluated with serum inhibin-B and FSH in relation to histological parameters. Based on the fertility potential, the boys were divided into three subgroups. At follow-up (median age: 2.7years) the boys were evaluated with FSH and in case of inhibin-B using multiple of the median (MoM). Inhibin-B MoM improved significantly at follow-up. In 32 boys with high FSH at orchidopexy 63% normalized FSH and 59% increased MoM inhibin-B, but 31% had impaired inhibin-B at follow-up. In 105 boys with transient hypogonadotropic hypogonadism, 52% increased inhibin-B MoM but 31% had impaired inhibin-B at follow-up. In 71 boys with normal FSH, inhibin-B, and G/T, 54% increased inhibin-B MoM and 15% had impaired inhibin-B at follow-up. The effect of the surgery was best in patients younger than 1year. Orchidopexy, especially before 1year of age, improves the fertility potential in bilateral cryptorchidism. At follow-up, 26% (54/208) had a risk of infertility based on inhibin-B.

Evaluation Inhibin B, FSH, and LH in Male with Thalassemia

Background : - Hypogonadism is the most frequently reported endocrine problem, affecting 70–80% of patients with thalassemia.Aim of study: -The current study is aimed to found correlation among inhibinB,FSH, LH and testosteronein male with thalassemia. Material and Subject: The study carried out 40 healthyvolunteermale, age range between (18-30) years,and enrolled 40 patients with thalassemia major age range between 18-30 years. The concentrations serum inhibin-B was estimated by two-side enzymelinked immunosorbent assays (ELISA), While FSH, and LH estimated by using Cobas e analyzers.Results: LH reduce significantly in thalassemia patients when compared with healthy individuals, while FSH and testosterone decrease significantly in thalassemia patients when compared with healthy. Inhibin B was reduced significantly in thalassemia patients when compared with healthy individuals.Conclusion:Infertility common in thalassemia patients, that correlation with decrease inhibin B.

Effect of electroacupuncture at different acupoints on follicle development and related factors in serum and ovary tissues of PCOS rats

To observe the effect of electroacupuncture (EA) at different acupoints on follicle development, expression of gonadotropins and their receptors and anti-Müllerian hormone(AMH), inhibin B(INHB) in polycystic ovarian syndrome (PCOS) rats, so as to explore its mechanisms underlying improvement of PCOS. Sixty female SD rats were randomized into six groups: control, model, Zusanli(ST36), Sanyinjiao(SP6), Guanyuan(CV4) and combination (ST36+SP6+CV4, n=10 rats/group). The PCOS model was established by gavage of Letrozole solution (1.0 mg/kg) once daily for 21 consecutive days. Rats of the control group were given 1% Carboxymethyl Cellulose (CMC, 1 mg/kg). EA (2 Hz) was applied to ST36, SP6, or/and CV4 for 20 min, once daily for 14 consecutive days. The number of follicles was counted, and the ovarian structure and follicular development were observed under light microscope after H.E. stain, and the contents of serum luteinizing hormone (LH), follicle-stimulating hormone (FSH), AMH, and INHB were assayed by enzyme-linked immunosorbent assay, and the ratio of LH/FSH was calcula-ted. The immunoactivity of LH receptor (LHR) and FSH receptor (FSHR) proteins was detected by immunohistochemistry. After modeling, the number of follicles at the growth stage, contents of serum LH, AMH and INHB, and ratio of LH/FSH were significantly increased, and serum FSH level and FSHR, LHR immunoactivity were remarkably decreased in the model group relevant to the control group (P<0.05, P<0.01). Following EA intervention, the number of follicles at the growth stage in the SP6, CV4 and combination groups, LH/FSH ratio and serum AMH levels in the 4 EA groups, INHB contents in the ST36, CV4 and combination groups were significantly reduced (P<0.05, P<0.01), while serum FSH contents in the 4 EA groups, FSHR immunoactivity at the early stage in the ST36 group and LHR immunoactivity at both early and late stages in the ST36 and CV4 groups were considerably increased in comparison with those of the model group (P<0.01, P<0.05). The therapeutic effect of SP6 was significantly superior to that of CV4 in down-regulating serum LH level (P<0.01), but significantly inferior to that of CV4 in up-regulating serum FSH content and in down-regulating LH/FSH ratio and serum AMH and INHB levels (P<0.05, P<0.01). The effect of CV4 was comparable to that of ST36 in up-regulating serum FSH, and in down-regulating serum LH/FSH ratio, AMH and INHB levels (P>0.05). EA of CV4, SP6, ST36 and ST36+CV4+SP6 can reduce the number of follicles at the growth stage and regulate the expression levels of gonadotropins in PCOS rats. The effects of EA of CV4 and ST36 are evidently better than those of EA of SP6 in up-regulating serum FSH content and in down-regulating LH/FSH ratio, and serum AMH and INHB levels, and EA of SP6 is evidently superior to EA of CV4 down-regulating LH level, but without synergistic effect among the 3 acupoints.

Application of serum AMH and INHB quantification in the auxiliary diagnosis of polycystic ovary syndrome

Objective To investigate the detection and significance of anti-Mullerian hormone (AMH) and inhibin B (INHB) in patients with polycystic ovary syndrome (PCOS). Methods This study randomly selected 240 PCOS patients from January to October 2018 in Obstetrics and Gynecology Hospital of Fudan University, and 240 healthy women who were admitted to the physical examination center of Obstetrics and Gynecology Hospital of Fudan University as control group during the same period. Retrospective study was adopted. Serum samples of patients were collected and the serum estradiol (E2), luteinizing hormone (LH), follicle stimulating hormone (FSH), testosterone (T), sex hormone binding globulin (SHBG), AMH and INHB were detected. The data were analyzed by single sample Kolmogorov-Smimov test, independent sample T test and logistic regression analysis. Results The detection values of AMH, INHB, E2, LH, FSH, T, SHBG and INHB/AMH in PCOS group were (8.55±3.17) ng/ml, (101.7±15.2) pg/ml, (63±50) pg/ml, (13.0±5.8) mIU/ml, (6.5±1.5) mIU/ml, (0.68±0.23) ng/ml, (62±52) nmol/ml and (24.03±26.35) respectively. In the control group, the detection values of AMH, INHB, E2, LH, FSH, T, SHBG, INHB and AMH were (4.34±2.07) ng/ml, (83.3±7.7) pg/ml, (66±25) pg/ml, (7.1±3.7) mIU/ml, (7.2±1.9) mIU/ml, (0.40±0.11) ng/ml, (67±37) nmol/ml and (42.83±62.22). The detection values of AMH, INHB, LH, T and SHBG in PCOS group were higher than those in control group (the t values were 9.843, 7.373, 9.021, 9.349 and 3.867), and the difference was statistically significant (P 0.05). The INHB/AMH value was lower than that in control group (the t value was -2.332), and the difference was statistically significant(P<0.05). The area under the curve of AMH, INHB and AMH+INHB in the diagnosis of PCOS was 0.762, 0.677 and 0.789, respectively. The cut-off value of AMH in predicting polycystic ovary syndrome was 6.96 ng/mL, the sensitivity was 61.0%, and the specificity was 82.1%. The cut-off value of INHB in predicting polycystic ovary syndrome was 94.9 pg/mL, with a sensitivity of 59.0% and a specificity of 74.1%. The sensitivity and specificity of combined detection of AMH and INHB in predicting polycystic ovary syndrome were 83.6% and 60.6%. The positive rates of ultrasound, T, AMH and INHB in PCOS group were 51.25%, 61.25%, 69.58% and 66.25%, respectively. Conclusion The combined detection of AMH and INHB may improve the sensitivity and specificity of PCOS diagnosis, and its serum level is stable. Key words: Polycystic ovary syndrome; Anti-Mullerian hormone; Inhibin B

Predictive significance of serum inhibin B on testicular haploid gamete retrieval outcomes in nonobstructive azoospermic men.

The purpose of this study was to determine the diagnostic accuracy of serum inhibin B (INHB) as a predictor of the retrieval outcome of testicular haploid gametes (spermatids and testicular spermatozoa) in nonobstructive azoospermic men. Serum hormone levels, testicular volume, and histological evaluation were performed in 403 Chinese nonobstructive azoospermic men. Testicular haploid gamete was successfully retrieved in 213 of 403 patients (52.85%). The haploid gamete group always had higher INHB levels than the non-haploid gamete group. According to the receiver operating characteristic (ROC) curve analysis, INHB was a good predictor of testicular haploid gamete retrieval outcome in all patients (sensitivity: 77.93% and specificity: 91.58%) and patients with normal follicle-stimulating hormone (FSH; sensitivity: 88.52% and specificity: 70.83%). The area under the ROC curve (AUC) of INHB was similar to that of FSH in all patients or patients with normal FSH. In patients with elevated FSH, INHB was superior to FSH in predicting the presence of haploid gamete (AUC: 0.73 vs 0.55, P < 0.05), with a sensitivity of 60.00% and a specificity of 80.28%. It concluded that serum INHB as an effective marker for spermatogenesis was a significant predictor of testicular haploid gamete retrieval outcomes in nonobstructive azoospermic men. Especially, INHB is superior to FSH in predicting the presence of haploid gamete in the patients with elevated FSH.

Impaired serum inhibin-B and number of germ cells in boys with cryptorchidism following heavily gestational maternal smoking

PurposeA meta-analysis including 11,900 cases showed that maternal gestational smoking was associated with increased risk of cryptorchidism. The aim of study was to investigate whether a hormone profile of cryptorchid boys and a supplementing histopathological evaluation of testicular biopsies could add detailed knowledge to the impact of maternal gestational smoking on pathogenesis of cryptorchidism. Methods601 cryptorchid boys aged 4 months to 14 years old were included. Because normal hormones have a pronounced age dependency, we compared results from boys whose mothers had smoked heavily (>10 cigarettes/day) during pregnancy with age matched cryptorchid controls of nonsmoking mothers (1:6). We studied: birthweight, germ-cell number/tubular cross section, frequency of germ cells positive for placental-like alkaline phosphatase (PLAP), gonadotropins and inhibin-B. Results501 boys were sons of nonsmokers, 72 boys of intermittent smokers and 28 boys of heavy smokers. 39%, 44% and 61% respectively had bilateral cryptorchidism. Compared to age-matched cryptorchid controls of nonsmoking mothers, sons of heavy smokers had lower birthweight (p = 0.006), germ-cell number/tubular cross section (p = 0.009), frequency of germ cells positive for PLAP (p = 0.037) and inhibin-B (p = 0.042). ConclusionsAll findings could be associated with placental dysfunction with altered human chorionic gonadotropin production well described in women smoking during pregnancy. Type of studyPrognosis study (prospective cohort study with >80% follow-up). Level of evidenceLevel 1.