Serum inhibin B determination is predictive of successful testicular spermextraction in men with non-obstructive azoospermia

Recent work indicates that serum inhibin B is a useful marker of spermatoge nesis and inhibin B production sufficient to maintain detectable serum conc entrations in adults depends on spermatogenic activity. The purpose of the present study was to investigate the usefulness of serum inhibin B measurem ent to predict the success of testicular sperm extraction (TESE) in 17 men with nonobstructive azoospermia to be treated by intracytoplasmic sperm inj ection (ICSI) (group 1), Two additional groups were used as positive contro ls; group 2 comprised 22 infertile men having obstructive azoospermia, and group 3, which included 29 semen donors having normal seminal parameters. F ollicle stimulating hormone (FSH) was significantly higher (P < 0.01) and i nhibin B significantly lower (P < 0.001), in group 1 as compared with group s 2 and 3, Serum inhibin B concentrations were significantly higher (P < 0. 001) among successful TESE men as compared with those having failed TESE. I n contrast, no differences were detected between these two groups with resp ect to serum FSH or testicular size. In addition, serum inhibin B but not F SH discriminated between successful and failed TESE in group 1 subjects as compared with control groups. According to the receiver operating character istics curve analysis, the best inhibin B value for discriminating between successful and failed TESE was >40 pg/ml (sensitivity 90%, specificity 100% ), It is concluded that inhibin B measurement is a useful non-invasive pred ictor of spermatogenesis and thus, all azoospermic males should have serum inhibin B concentrations determined in addition to FSH measurement and kary otyping prior to undergoing TESE.