Serum Inhibin Research Articles

The protective role of spermine against male reproductive aberrations induced by exposure to electromagnetic field – An experimental investigation in the rat

The exponentially increasing use of electromagnetic field (EMF)-emitting devices imposes substantial health burden on modern societies with particular concerns of male infertility. Limited studies have addressed the modulation of this risk by protective agents. We investigated the hazardous effects of rat exposure to EMF (900 MHz, 2 h/day for 8 weeks) on male fertility and evaluated the possible protective effect of the polyamine, spermine, against EMF-induced alterations. Exposure to EMF significantly decreased sperm count, viability and motility, and increased sperm deformities. EMF-exposed rats exhibited significant reductions in serum inhibin B and testosterone along with elevated activin A, follicle-stimulating hormone, luteinizing hormone and estradiol concentrations. Testicular steroidogenic acute regulatory protein (StAR), c-kit mRNA expression and testicular activities of the key androgenic enzymes 3β- and 17β-hydroxysteroid dehydrogenases were significantly attenuated following exposure to EMF. Exposure led to testicular lipid peroxidation, decreased catalase and glutathione peroxidase activities and triggered nuclear factor-kappa B p65, inducible nitric oxide synthase, cyclooxygenase-2 and caspase-3 overexpression. EMF-exposed rats showed testicular DNA damage as indicated by elevated comet parameters. Spermine administration (2.5 mg/Kg/day intraperitoneally for 8 weeks) prevented EMF-induced alterations in the sperm and hormone profiles, StAR and c-kit expression and androgenic enzyme activities. Spermine hampered EMF-induced oxidative, inflammatory, apoptotic and DNA perturbations. Histological and histomorphometric analysis of the testes supported all biochemical findings. In conclusion, rat exposure to EMF disrupts sperm and hormone profiles with underlying impairment of steroidogenesis and spermatogenesis. Spermine confers protection against EMF-associated testicular and reproductive aberrations, at least in part, via antioxidant, anti-inflammatory and anti-apoptotic mechanisms.

Biomarkers of ovarian reserve in childhood and adolescence: A systematic review.

Certain medical disorders as well as their management may affect gonadal function. Recent advances in the management of these conditions accompanied by the availability and success of methods of fertility preservation has highlighted the need for assessment of ovarian reserve in childhood and adolescence. Serum anti-Mullerian hormone (AMH) and antral follicle count are well established markers of ovarian reserve and serum inhibin has also been used. However, literature on reference ranges for ovarian reserve markers in this age-group is relatively scarce. Thus, our aim was to evaluate published data to estimate reference values of ovarian reserve makers in childhood and adolescence. We performed a systematic review of the literature reporting ovarian reserve markers in childhood and adolescence. We included only those studies examining markers of ovarian reserve in the normal healthy population between the ages of 0 and 19years. PROSPERO registration: CRD42018119064. Serum AMH emerged as the most common biomarker assessed. Serum AMH was detectable at birth and, after a transient increase in infancy, increased steadily in childhood. Following a slight decrease at puberty, levels were constant throughout adolescence with a peak in adolescence or early adulthood. The mean serum AMH values during infancy, childhood and adolescence were 10.55, 22.32 and 31.84pmol/L, respectively. The corresponding median values were 9.85, 24.49 and 26.32pmol/L. It was not possible to construct age-specific reference intervals because of methodological heterogeneity, variations in the assay used to measure AMH and differing interval width for age used in included studies. Serum inhibin showed an increase from childhood to adolescence, with median serum inhibin values of 53.86pg/mL in adolescence. Antral follicle count showed a significant positive correlation with serum AMH and a median value of 30.52 in adolescence. We summarize the trends and levels of biomarkers of ovarian reserve from birth until young adulthood. Peak levels of serum AMH are reported in adolescence or early adulthood. We have reported median/mean values for serum AMH in different age-groups based on data pooled from several studies, which may be used as a reference when evaluating ovarian reserve in childhood and adolescence especially when considering fertility preservation.

The Associated of Serum Inhibin A Levels in Severe Preeclampsia

Objective: to prove the associated of serum Inhibin A levels in severe preeclampsia.
 Method: this study was an observational analytic research with cross-sectional design. The subject of this study consists of 23 samples of normotensive pregnancy and 23 of samples severe preeclampsia who meet the inclusion and exclusion criteria.This study was conducted and evaluated fromSeptember 2016 until December 2016 at Department of Obstetrics and Gynecology Faculty of Medicine University of Sam Ratulangi Prof. Dr. R. D. Kandou Hospital Manado and satellite hospitals. Samples were analyzed using ELISA method at Prodia laboratory. Data were analyzed with SPSS version 20.0
 Result: Mean serum Inhibin A levels in normotensive pregnancy is 477,22pg/ml while mean in severe preeclampsiais 2712,39 pg/ml with p value = 0,000.
 Conclusion: Levels of serum Inhibin A in severe preeclampsia significantly higher compared to normotensive pregnancy.
 Keywords: inhibin A, normotensi, severe preeclampsia
 
 
 Tujuan: untuk membuktikan hubungan kadar inhibin A serum pada preeclamsia berat.
 Metode: penelitian ini merupakan studi analitik observasional dalam bentuk desain potong lintang. Dilakukan pemeriksaan kadar Inhibin A serum pada 46 sampel ibu hamil yang memenuhi kriteria inklusi dan eksklusi, terdiri atas 23 kelompok preeclamsia berat dan 23 kelompok kehamilan normotesi. Penelitian dilaksanakan dan dievaluasi sejak bulan September 2016 sampai Desember 2016 di Bagian Obstetri dan Ginekologi Fakultas Kedokteran Universitas Sam Ratulangi / RSU Prof. dr. R. D. Kandou Manado dan rumah sakit jejaring. Analisis sampel dilakukan di Laboratorium Prodia Jakartamenggunakan metode ELISA. Data dianalisis denganSPSS versi 20.0.
 Hasil: rerata kadar Inhibin A serum pada kelompok kehamilan normotesi yaitu 477,22 pg/mlsedangkan rerata pada kelompok preeklamsia berat yaitu 271,.39 pg/ml dengan nilai p=,.000.
 Kesimpulan: kadar Inhibin A serum pada preeclampsia berat lebih tinggi secara bermakna dibandingkan dengan kehamilan normotensi.
 Kata kunci: inhibin A, normotensi, preeclamsia berat

Sertoli Cell Function in Young Males with Metabolic Syndrome.

Context:The last few decades have witnessed an alarming increase in the prevalence of the metabolic syndrome (MetS) worldwide including India. Apart from the known risks of MetS in terms of cardiovascular risk and mortality, there is increasing evidence that it also leads to alteration in testicular function and fertility.Aims:To assess the presence of hypogonadism and Sertoli cell dysfunction in young adult males with MetS and correlate these parameters with different components of the MetS.Settings and Design:Cross-sectional study conducted in the Department of Endocrinology, Gauhati Medical College, a tertiary care hospital in North East India.Subjects and Methods:Young adult males with MetS aged 20–40 years and age-matched healthy males who served as controls were examined clinically. Laboratory investigations done in the fasting state included blood glucose, lipid profile, serum follicle-stimulating hormone (FSH), inhibin B and total testosterone (Te). Semen was collected after 3 days abstinence and analysis done.Statistical Analysis:Baseline parameters were presented as median and ‘Kruskal–Wallis’ test was used to compare them. Pearson test and multiple regression analysis were used to assess the correlation and association between variables.Results:Fifty cases with MetS and 30 controls were included in the study. Subjects with MetS had significantly lower levels of total Te, FSH and inhibin B. They also had significantly lower semen volume, sperm count and total as well as progressive motility. There was a significant negative correlation of waist circumference and positive correlation of inhibin B with total sperm count. A significant negative association of serum triglycerides with semen volume was also found.Conclusion:MetS is a state of hypogonadotropic hypogonadism as reflected by low total Te, FSH and inhibin B levels with semen abnormalities reflecting Sertoli cell dysfunction.

The distance between the embryo and yolk sac associated with inhibin A in the first-trimester pregnancy – which is the novelty?

Objective. The etiology of embryonic demise is multifactorial, with chromosomal abnormalities being the most common (40%). The purpose of this study is to evaluate the correlation between a serum biomarker, inhibine A, and an ultrasonographic parameter, the distance between yolk sac (YS) and embryo (DYSE), in assessing the prognosis of pregnancy evolutivity in the first trimester. Method. The study is a case-control prospective analysis that includes two groups of patients: 81 patients with first-trimester pregnancy in evolution, and 89 patients with embryonic demise, all of the patients having amenorrhea between 6 and 11 weeks. The endovaginal ultrasonographic exploration was performed to evaluate the distance between the lower pole of the embryo and the yolk sac. From each subject enrolled in the study, 20 ml of blood was collected for inhibin A dosing. Results. Regarding the DYSE in the case group, lower values were observed compared to the control group, the difference being statistically significant. In the statistical analysis of serum inhibin A values, statistically significant differences were observed between the two groups (p<0.05). Conclusions. DYSE has a high positive predictive value in identifying pregnancies with potentially reserved evolutivity, this study demonstrating that a DYSE<3 mm may lead to an unfavorable evolution of pregnancy. The low serum level of inhibine A is associated with an increased rate of non-viable embryos.

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.

Naringenin palliates cisplatin and doxorubicin gonadal toxicity in male rats

Cisplatin (CP) and doxorubicin (DX) can cause testicular injury by inducing oxidative/nitrosative stress, inflammation, and apoptosis, Naringenin (NG) has antioxidant, antinitrative, anti-inflammatory, and anti-apoptotic effects. This study investigated the potential ability of NG to block gonadotoxicity induced CP and DX in male rats. The rats received one injection of either CP (10 mg/kg, i.p.) or DX (15 mg/kg, i.p.), and treated with NG (50 mg/kg/day, p.o.) for 10 days beginning 6 days prior to CP and DX administration. NG significantly prevented the decreases of serum testosterone and inhibin B in rats received CP and DX. Additionally, NG significantly decreased the elevated testicular malondialdehyde, tumor necrosis factor-α/interleukin-10 ratio, and caspase-3 in CP- and DX-treated rats. NG also significantly raised the decreased testicular Bcl-2/Bax ratio, and total antioxidant status in CP- and DX-challenged rats. In addition, NG significantly increased P-glycoprotein level in testes of rats received CP and DX. Moreover, NG significantly decreased the testicular histopathological injury, and immunohistochemical expression of inducible nitric oxide synthase induced by CP and DX in rat testes. It was concluded that NG impeded gonadotoxicity of CP and DX in male rats by mitigating oxidative stress, nitrosative stress, inflammation, and apoptosis.

Recombinant Human FSH Treatment Outcomes in Five Boys With Severe Congenital Hypogonadotropic Hypogonadism.

ContextRecombinant human FSH (r-hFSH), given to prepubertal boys with hypogonadotropic hypogonadism (HH), may induce Sertoli cell proliferation and thereby increase sperm-producing capacity later in life.ObjectiveTo evaluate the effects of r-hFSH, human chorionic gonadotropin (hCG), and testosterone (T) in such patients.Design and SettingRetrospective review in three tertiary centers in Finland between 2006 and 2016.PatientsFive boys: ANOS1 mutation in two, homozygous PROKR2 mutation in one, FGFR1 mutation in one, and homozygous GNRHR mutation in one. Prepubertal testicular volume (TV) varied between 0.3 and 2.3 mL; three boys had micropenis, three had undergone orchidopexy.InterventionsTwo boys received r-hFSH (6 to 7 months) followed by r-hFSH plus hCG (33 to 34 months); one received T (6 months), then r-hFSH plus T (29 months) followed by hCG (25 months); two received T (3 months) followed by r-hFSH (7 months) or r-hFSH plus T (8 months).Main Outcome MeasuresTV, inhibin B, anti-Müllerian hormone, T, puberty, sperm count.Resultsr-hFSH doubled TV (from a mean ± SD of 0.9 ± 0.9 mL to 1.9 ± 1.7 mL; P < 0.05) and increased serum inhibin B (from 15 ± 5 ng/L to 85 ± 40 ng/L; P < 0.05). hCG further increased TV (from 2.1 ± 2.3 mL to 8.6 ± 1.7 mL). Two boys with initially extremely small testis size (0.3 mL) developed sperm (maximal sperm count range, 2.8 to 13.8 million/mL), which was cryopreserved.ConclusionsSpermatogenesis can be induced with gonadotropins even in boys with HH who have extremely small testes, and despite low-dose T treatment given in early puberty. Induction of puberty with gonadotropins allows preservation of fertility.

Prevalence of Testicular Adrenal Rest Tumor and Factors Associated with Its Development in Congenital Adrenal Hyperplasia

Background: Testicular adrenal rest tumors (TART) can cause infertility in congenital adrenal hyperplasia (CAH) males. Aims: To determine TART prevalence in patients with CAH due to 21-hydroxylase deficiency (21-OHD) and evaluate possible factors associated with its development. Methods: This is a descriptive and analytical cross-sectional study evaluating males with the classical form of 21-OHD through testicular ultrasonography and serum inhibin B dosages. Data on prescribed glucocorticoid dose and serum levels of 17- hydroxyprogesterone (17-OHP), androstenedione (Andro), ACTH, renin, and LH were obtained from medical records. Results: Thirty-eight males were evaluated. The mean age on ultrasonography was 15.2 ± 6.7 (3–27) years. Nine patients (23.7%) had TART, 4 of them were prepubertal and the youngest was 5 years old. No association was found between TART and 21-OHD phenotype, glucocorticoid dose, or 17-OHP, ACTH, LH, renin, and inhibin B levels measured in the 6 preceding years. However, 50% of the patients who presented increased Andro 2 years prior to the evaluation had TART (p = 0.018, OR = 8.00 [95% CI: 1.42–44.92]), whereas in the normal Andro group only 16.7% had tumors. Conclusion: This study showed that TART can occur in prepubertal patients and that disease control could be a factor associated with its development. Therefore, we suggest investigating TART development early in childhood, mainly in poorly controlled 21-OHD patients.

Evaluation of testicular function in prepubertal children.

The assessment of testicular function is not currently performed in childhood. The aim of this review was to address the usefulness of serum Anti-Müllerian Hormone (AMH), inhibin B, and testicular volume (TV) evaluation in children. Serum AMH and inhibin B levels reflect Sertoli cells (SCs) health and number, SCs maturation degree and their exposure to FSH and to intra-tubular testosterone (T). These hormones might be helpful in discriminating between congenital central hypogonadism (cHH) and constitutional delay in growth and puberty (CDGP) and in case of clinical suspicious of precocious puberty. Furthermore, low AMH and/or inhibin B levels have been observed in children with primary testicular disorders, suggesting the existence of SC dysfunction. TV also provides useful information on testicular health. Recently, a medical calculator, requiring testis length and the stage of genital development, has been developed to easily derive TV. The evidence supports the usefulness of AMH, inhibin B and TV evaluation for the early diagnosis of puberty disorders and primary testicular damage. We suggest the measurement of TV by using the medical calculator in all children and to reserve AMH and inhibin B measurements to those cases of no testicular growth, clinical suspicious of puberty disorders or in children at risk for spermatogenesis damage. This work-up might allow the early detection of testicular tubular damage which, in turn, may be useful to prevent the oncoming male infertility in adulthood.

CLINICAL CASE OG GRANULAR CELL OVARIAN TUMOR

Ivestigation of the diagnostics issues, treatment of granulosa-cell tumors of the ovary (GCTO), especially granulosa-cell tumors of the juvenile type (GCTJT), showed insufficient study of the problem, and many questions are quite contradictory. This is due to their relatively rare occurrence and a small number of analyzed observations, which does not allow us to draw conclusions on the main issues of problems with the required degree of reliability. The articlepresents a clinical case of GCTJT in a girl aged 17 years, which occurred in the practice of the doctors at the gynecological department of a hospital. In the case of ovaries tumor formation presence with a solid and cystic component GCTJT should be suspected. Tumor-like formations of applications with a solid component require the determination of antimulhuric hormone as a marker of GCTO. In case of GCTJT suspicion, it is useful to supplement the diagnostic stage by determining of the serum inhibin B level as a marker of the disease. The oncomarkers СА-125 and НЕ-4 are not specific markers GCTO. In the case, described below, the level of tumor markers of ovaries of CA-125 and NE4 was in the normal range. At the same time, the level of antimuler hormone, whose value was 15 times higher than the maximal reference value, was more indicative. The main treatment of GCTO is surgical. The operation allows to obtain the maximum diagnostic information for the planning of the further tactics. Introduction of on-line communication with oncologists in case of suspicion of malignancy of the process, improves the quality of diagnosis and provision of surgical care, since GCTO are rarely encountered in the practice of operating gynecologists and the most important is the intraoperative choice tactics. The familiarization of specialists with the clinical case of granulosic-cell tumor of the juvenile type ovary, described below - took place in our practice and we believe it will be useful to gynecologists.

Effects of electroacupuncture at "Zhongliao" (BL 33) and "Tianshu" (ST 25) on ovarian function in rats with premature ovarian insufficiency

To explore the effects of electroacupuncture (EA) at "Zhongliao" (BL 33) and "Tianshu" (ST 25) on ovarian function in rats with premature ovarian insufficiency (POI). A total of 48 SD female rats with regular estrus were divided into a blank group (n=8), a model group (n=10), an EA group (n=10), a binding group (n=10) and a tamoxifen (TAM) group (n=10). The rats in the model group, EA group, binding group and TAM group were all treated with intraperitoneal injection of 4-vinylcyclohexene diepoxide (VCD, 160 mg/kg) for 15 consecutive days to establish the model of POI; the rats in the blank group were treated with normal diet. After the model was established successfully, the rats in the EA group were treated with EA at "Zhongliao" (BL 33) and "Tianshu" (ST 25) with continuous wave (1 to 3 Hz, 0.1 to 1 mA) for 20 minutes, once a day (five times a week) for the first two weeks and once every other day (three times a week) for the following two weeks. The rats in the TAM group were treated with subcutaneous injection of tamoxifen (1mg/kg), once a day (five times a week) for the first two weeks and once every other day (three times a week) for the following two weeks. The rats in the binding group were bound by a small sack as the EA group. The rats in the blank group and the model group were treated with normal diet. After four weeks, the sexual gland weight and index were tested in each group; the ELISA method was applied to test the level of anti-mllerian hormone (AMH) and inhibin B; the morphology of ovary was observed; the number of primordial follicles, primary follicle, antral follicle and atretic follicle was counted; the expression of insulin-like growth factor-1 (IGF-1) and insulin-like growth factor-1 receptor (IGF-1R) were measured. (1) Compared with the blank group, the ovary weight, ovary index, uterus weight and uterus index were significantly decreased after treatment in the model group, EA group, binding group and TAM group (all P<0.01); but the differences between the model group and the EA group, binding group, TAM group were not significant (all P>0.05). (2) Compared with the blank group, the levels of serum AMH, inhibin B and E2 were significantly reduced; the levels of FSH and LH were significantly increased in the model group; EA group, binding group and TAM group (all P<0.01). Compared with the model group, the levels of serum AMH, inhibin B and E2 were significantly increased, the level of FSH and LH were significantly reduced in the EA group and TAM group (all P<0.01). (3) Compared with the blank group, in the model group, EA group, binding group and TAM group the ovary was dark red and pale, surrounded by particle or not; the morphology was small and atrophic; the primordial follicles was reduced even vanished; the structure of primary follicle was damaged and loosely arranged; the mature follicle was few; the atretic follicle and interstitial gland were increased. (4) Compared with the blank group, the expressions of IGF-1 mRNA and IGF-1R mRNA were increased in the model group (all P<0.01); compared with the blank group, the expression of IGF-1 mRNA was increased in the binding group (P<0.05), but that of IGF-1R mRNA was not significantly different (P>0.05); compared with the model group, the expression of IGF-1 mRNA was not significantly different in the EA group, binding group and TAM group (all P>0.05), but that of IGF-1R mRNA was reduced (P<0.05, P<0.01). EA at "Zhongliao" (BL 33) and "Tianshu" (ST 25) has improvement effect on ovarian function in rats with VCD-induced POI, which is likely to be related to regulating the IGF-1R mRNA expression to improve the IGF-1/ IGF-1R axis.

Sexual dimorphism in postnatal gonadotrophin levels in infancy reflects diverse maturation of the ovarian and testicular hormone synthesis.

The postnatal gonadotrophin surge is sexually dimorphic: FSH levels predominate in girls and LH levels in boys. However, in preterm (PT) girls, both gonadotrophin levels are higher than in PT boys. To evaluate how gonadal maturation contributes to the sex differences in FSH and LH. Monthly follow-up of 58 full-term (FT, 29 boys) and 67 PT (33 boys) infants from 1week (D7) to 6months of age (M1-M6). Analyses were also carried out according to postmenstrual (PM) age in PT infants. Urinary LH, FSH, oestradiol (E2), testosterone (T) and serum inhibin B (InhB) levels. High gonadotrophin levels in PT girls abruptly decreased (P<.001) by M2, corresponding to a PM age of 38-42weeks, and LH levels fell below the levels found in boys. This decrease was parallel to a steep increase in E2 levels (P<.001), and, from M4 to M6, LH and E2 correlated positively in PT girls (P<.01). T levels in PT boys increased earlier than E2 levels in PT girls. In addition, InhB levels were high in PT boys already at D7, in contrast to low InhB in PT girls. InhB and FSH correlated negatively in the whole group (P<.001). Ovarian hormone synthesis is immature and incapable of responding to gonadotrophin stimulus before 38-42 PM weeks in PT girls, which may explain their highly elevated FSH and LH levels. The higher InhB levels in boys compared to girls may explain sexual dimorphism in FSH levels.

Endocrine disrupting metals lead to alteration in the gonadal hormone levels in Nigerian e-waste workers

BACKGROUNDElectronic waste (e-waste) is known to contain thousands of toxic chemicals and metals, many of which have identified endocrine disruption potentials even at low blood concentrations resulting from occupational and environmental exposures. E-waste crude reprocessing in Nigeria is massive and a growing number of Nigerians are occupationally exposed. The present study aimed to determine changes in gonadal hormone levels associated with occupational crude e-waste reprocessing in Nigerian male e-waste workers. METHODSThis cross-sectional study which was carried out in Benin City, South-South Nigeria recruited male e-waste workers (n=63); and apparently healthy non e-waste workers (n=41), as exposed and unexposed participants respectively. Male fertility hormones which includes luteinizing hormone (LH), follicle stimulating hormone (FSH), testosterone (TESTO) and prolactin (PROL); as well as progesterone (PROG), estrogen (EST) and inhibin (INH) were determined using enzyme linked immunosorbent assay (ELISA) methods; whole blood levels of chromium, cadmium, arsenic and mercury were determined using Inductively Coupled Plasma Mass Spectrometry. RESULTSLevels of TESTO, PROG, LH and FSH; as well as PROL and EST were significantly lower in e-waste workers compared with unexposed participants (p&lt;0.05). In contrast, serum INH was significantly higher in e-waste exposed population compared with the unexposed. In addition, chromium correlated significantly and negatively with testosterone, progesterone and estrogen, while inhibin correlated positively with chromium. Similar correlation patterns were observed for cadmium, arsenic and mercury. CONCLUSIONNigerian e-waste workers experienced reduced levels of key gonadal hormones and this may be associated with occupational exposure to endocrine disrupting metals in e-waste.

Anti-Mullerian Hormone and Inhibin B Levels in Obese Boys; Relations with Cardiovascular Risk Factors.

Obesity may reduce sertoli cell functions in men. The aim of the study was to investigate antimullerian hormone (AMH) and inhibin B levels (sertoli cell markers) in obese boys and their relations to cardiovascular risk factors such as insulin sensitivity index, aortic intima media thickness (aIMT) and high sensitive c-reactive protein (hsCRP). 121 obese and 38 healthy lean adolescents were included in the study. Serum AMH, inhibin B, gonadotropins, total testosterone, lipids, hsCRP, glucose and insulin levels were detected and analyzed. Insulin resistance was analyzed using the homeostasis model assessment (HOMA-IR). aIMT was measured by high-resolution B-mode ultrasonography. Serum AMH, inhibin B and total testosterone levels were lower in the obese adolescents (p=0.01, p=0.009 and p=0.002, respectively). aIMT measurements (p<0.001, 0.63±0.09 and 0.47±0.06 mm, respectively) and hsCRP levels (p<0.001, 2.5±0.4 and 0.66±0.69 mg/L, respectively) were significantly increased in the obese group. Obese with IR group had decreased AMH levels (p=0.02, 53.0±20.5 and 66.7±19.5 ng/mL, respectively) and increased triglycerides, HOMA-IR, aIMT measurements than non-IR obese group. AMH levels were correlated negatively with body mass index (r:-0.108, p=0.03), HOMA-IR (r:-0.358, p=0.003) and fasting insulin levels (r:-0.389, p=0.001) in obese group with IR. We found that concentrations of both sertoli cell markers (AMH and inhibin B) were significantly lower in obese pubertal boys especially in obese with IR. Obesity and IR might be important factors for the sertoli cell impairment in pubertal boys.

A study of Inhibin a-16C&gt;T gene polymorphism and other reproductive hormones in the diagnosis of Premature Ovarian Failure in Egyptian Women undergoing ICSI

Background: Premature ovarian failure (POF) or poor ovarian response is a syndrome characterized by amenorrhea for duration of 4-6 months or more, hypo-estrogenism and elevated serum FSH concentration (FSH > 40 IU/1) before age of 40 years. The POF may arise through different events including: reduction of primordial follicle pool; acceleration of follicular atresia; alteration of primordial follicles maturation/recruitment Inhibin is a product of granulosa cells. Onset of POF can be a result of inhibin alpha genetic abnormalities, the most extensively studied genetic abnormality is 16C>T polymorphism. Objectives: The present study was undertaken to evaluate whether INHa-16C>T gene polymorphism could be a predictive marker for POF in the Egyptian females undergoing ICSI. Also, to identify role of the ovarian hormones like; FSH, LH, estradaiol, progesterone, anti-mullarian hormone, activin and inhibin in the dignosis of POF. Patients and methods: All cases were recurted from the Gynecology and Obstetric Department, Mansoura University, Egypt. All women were subjected to history taking including demographic data, menstrual and reproductive characteristics and history of hormonal therapy. The study group included 50 women with symptoms and signs suggestive of ovarian failure; their mean age was 31.5± 4.88 years. The control group included 50 healthy women with normal hormonal profile with male factors infertility, their mean age 29.05+3.3 years. Venous blood samples were collected for assay of follicle stimulating hormone (FSH), luteinizing hormone (LH), anti-mullarian hormone (AMH), inhibin and activin using enzyme linked immunosorbent assay. Genomic DNA was isolated from EDTA-anticoagulated peripheral blood using DNA extraction kit. Results: Women with POF showed a highly significant increase in the mean FSH and LH levels compared to control group. There is a statistically significant decrease of the mean serum inhibin and inhibin/activin ratio in women with POF compared to control women. In women with POF, the frequencies of homozygous genotypes CC, heterozygote genotypes CT and homozygote genotypes TT of the INHa-16C>T polymorphism were 70% (35/50), 24% (12/50) and 6% (3/50). The C allele was present in 82% of patients with POF and in 73% of the control group, whereas the T allele was present in 12% and 27% respectively. Conclusion: INHa-16C>T gene polymorphisms is not considered as a risk factor for POF among Egyptian women.

The impact of antenatal Bisphenol A exposure on male reproductive function at 20-22 years of age.

Bisphenol A (BPA) is a ubiquitous chemical suspected to possess oestrogenic hormonal activities. Male population studies suggest a negative impact on testicular function. As Sertoli cell proliferation occurs during fetal or early postnatal life, it is speculated that oestrogenic environmental exposures may influence mature testicular function. Among 705 Western Australian Pregnancy Cohort (Raine) Study men aged 20-22 years, 404 underwent testicular ultrasound examination (149 had maternal serum available), and/or 365 provided semen (136 had maternal serum) and/or 609 serum samples for sex steroids, gonadotrophins and inhibin B analysis (244 had maternal serum). Maternal serum collected at 18 and 34 weeks' gestation was pooled and assayed for concentrations of total BPA (free plus conjugated) as an estimate of antenatal exposure. Testicular volume was calculated by ultrasonography, and semen analysis performed. Serum LH, FSH and inhibin B were measured by immunoassay; testosterone, oestradiol, oestrone andBPA were measured by liquid chromatography-mass spectrometry. BPA levels were detectable in most (89%) maternal serum samples. After adjustment for maternal smoking, abstinence and varicocele, sperm concentration and motility were significantly correlated to maternal serum BPA (r = 0.18; P = 0.04 for both). No other associations of maternal serum BPA with testicular function were observed.

Inhibin-A and inhibin-B in cyclic and pregnant mares, and mares with granulosa-theca cell tumors: Physiological and diagnostic implications

Studies in mares have examined serum inhibin concentrations using immuno-assays unable to distinguish dimeric inhibin-A from inhibin-B isoforms. Inhibin-A and inhibin-B immuno-assays were used to investigate concentrations in cyclic mares, young and old (6 vs 19 years old, respectively) mares following hemi-ovariectomy, mares during pregnancy and in mares with confirmed granulosa cell tumors (GCTs). Mares with inter-ovulatory intervals of 26 days had ovulatory peaks of inhibin-A averaging 80 pg/mL with a mid-cycle nadir of 5 pg/mL. Inhibin-A and inhibin-B concentrations were highly correlated (r = + 0.79, P < 0.01) though peak and nadir concentrations of inhibin-B were not significantly different. However, the ratio of inhibin-A to inhibin-B (A/B) changed significantly through the cycle, highest at ovulation and <1 (more inhibin-B than –A) at mid-cycle. Two mares with grossly extended inter-ovulatory intervals demonstrated mid-cycle inhibin-A (and inhibin-B) excursions suggestive of follicular waves. Follicle-stimulating hormone was negatively correlated with inhibin-A and –B concentrations in all 6 mares. Hemi-ovariectomy in young mares resulted in a significant decrease in inhibin-A and inhibin-B concentrations one day later (P < 0.05) but older mares did not, suggesting a possible extra-ovarian source(s) of these hormones. Both inhibin isoforms dropped to very low levels during pregnancy (P < 0.0001), inhibin-A (P < 0.0001) more rapidly than –B (P < 0.05), so that inhibin-B became the predominant measured form throughout most of gestation (P < 0.05). Mares with confirmed GCTs had elevated inhibin-B concentrations more reliably than inhibin-A but neither inhibin-A or -B was correlated with anti-Müllerian hormone concentrations. Collectively, concentrations of inhibin-A and –B were aligned with physiological events in healthy mares, though more pronounced cyclic changes were seen with inhibin-A. Inhibin-B concentrations were significantly associated with GCTs (P < 0.01), inhibin-A concentrations were not. While both inhibin-A and –B concentrations track physiological events such as cyclic follicular activity, only inhibin-B concentrations effectively signal ovarian neoplasia in mares.

Effects of Vitamin D Supplementation on Semen Quality, Reproductive Hormones, and Live Birth Rate: A Randomized Clinical Trial.

Results of animal models and cross-sectional cohort studies have suggested a beneficial role for vitamin D in male reproduction. Determine the effect of vitamin D and calcium supplementation on semen quality in infertile men with serum 25-hydroxyvitamin-D (25OHD) levels ≤50 nmol/L. A single-center, triple-blinded, randomized clinical trial. A total of 1427 infertile men were screened to include 330; 1002 men did not meet inclusion criteria and 95 did not wish to participate. The active group received cholecalciferol 300,000 IU initially, then 1400 IU cholecalciferol and 500 mg of calcium daily for 150 days; the other group received placebo. Serum concentrations of 25OHD and 1,25-dihydroxyvitamin D3 were significantly higher in men in the treatment group compared with the placebo group. Vitamin D supplementation was not associated with changes in semen parameters, although spontaneous pregnancies tended to be higher in couples in which the man was in the treatment group [7.3% vs 2.4%, Δ5.0% (-0.6%; 10.5%)]. Vitamin D treatment in a subgroup of oligozoospermic men increased the chance for a live birth compared with placebo [35.6% vs 18.3%, Δ17.3% (1.6%; 32.9%)]. Moreover, serum inhibin B levels were higher in men deficient in vitamin D who were randomly assigned to receive high-dose vitamin D [193 pg/mL vs 143 pg/mL, Δ49 pg/mL (8; 91 pg/mL)]; however, the increase in sperm concentration was not significantly higher than in the placebo group (P = 0.07). High-dose vitamin D supplementation did not improve semen quality in vitamin D-insufficient infertile men. The positive impact of vitamin D supplementation on live birth rate and serum inhibin B in oligozoospermic and vitamin D-deficient men may be of clinical importance and warrant verification by others.

Demographic characteristics and AMH levels in rural and urban women participating in an IVF programme.

The primary aim of this preliminary study was to compare the IVF results of couples living in rural and urban areas. Additionally, the ovarian reserve parameters, such as AMH concentrations, were compared for the same groups. The database of 1,265 women undergoing in vitro fertilization at the Invicta Fertility Center between May 2011-July 2012 were retrospectively analyzed. Women undergoing their first assisted reproductive technology cycle with ICSI, stimulated according to the long protocol, and whose AMH levels were measured using the same DSL kit, were selected. Ultimately, 651 women were included in the study. All participants were categorized based on the area where they live: rural areas, small towns (<100,000 inhabitants) and large cities (>100,000). The mean age of the patients living in large cities was significantly higher in comparison to those from rural areas and small towns. A significantly higher pregnancy body mass index (BMI) was found in women from rural areas in comparison to the women living in small and large towns. Serum AMH and inhibin B concentrations, number of ampules of gonadotropins, and antral follicle count (AFC), did not differ significantly among the groups. The study showed no significant differences among the groups in terms of clinical pregnancy rate, both per started cycle and per embryo transfer. No significant differences were found in IVF outcomes among the groups inhabiting rural areas, small and large cities.