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ObjectivesInhibin B (IB) levels and the IB: follicle-stimulating hormone (FSH) ratio (IFR), biomarkers of global Sertoli cell function, show a strong relationship with male fertility. The aim of the study was to examine the prevalence of impaired fertility potential in HIV-infected men and the influence of antiretroviral therapy (ART) on fertility biomarkers. MethodsA cross-sectional study with sequential sampling was carried out. A total of 169 clinically stable patients in a cohort of HIV-infected men undergoing regular ambulatory assessment in a tertiary hospital were included. The mean [ standard deviation (SD)] age of the patients was 42.6 8.1 years, all were clinically stable, 61.5% had disease classified as Centers for Disease Control and Prevention (CDC) stage A, and were na?ve to ART or had not had any changes to ART for 6 months (91.1%). Morning baseline IB and FSH concentrations were measured using an enzyme-linked immunosorbent assay (ELISA) and an electrochemiluminescent immunoassay (ECLIA), respectively. A multivariate logistic regression model was used to identify factors associated with impaired fertility, defined as IB < 119 pg/mL or IFR < 23.5. ResultsThe mean (+/- SD) IB level was 250 +/- 103 pg/mL, the median [interquartile range (IQR)] FSH concentration was 5.1 (3.3-7.8) UI/L and the median (IQR) IFR was 46.1 (26.3-83.7). The prevalence of impaired fertility was 21.9% [95% confidence interval (CI) 16.3-20.7%]. Negative correlations of body mass index and waist: hip ratio with FSH and IB levels were observed (P < 0.01), while a sedentary lifestyle and previous nevirapine exposure were associated with a decreased risk of IB levels 25th percentile in multivariate analysis. Only older age, as a risk factor, and sedentary lifestyle, with a protective effect, were independently associated with impaired fertility in multivariate analysis. ConclusionsGlobal testicular Sertoli cell function and fertility potential, assessed indirectly through serum IB levels and IB: FSH ratio, appear to be well maintained in HIV-infected men and not damaged by ART.

Made available in DSpace on 2018-12-11T16:50:51Z (GMT). No. of bitstreams: 0 Previous issue date: 2018-03-01 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

Regulation of human ovarian steroidogenesis differs from other species and precise knowledge on how human small antral follicles (hSAF) develop and acquire competence for continued growth and steroid output is still incomplete. The present study has characterized almost 1,000 normal hSAF collected in connection with cryopreservation of ovarian tissue for fertility preservation. The antral follicles (ranging from 3 to 13 mm) were generally aspirated from one ovary surgically removed during the natural cycle, and the follicular fluid (FF) and the granulosa cells (GC) were isolated and snap-frozen. In FF, the following hormones were measured: inhibin-B, inhibin-A, AMH, follistatin, PAPP-A, estradiol, progesterone, testosterone, and androstenedione. In GC, mRNA gene expressions using q-PCR were measured for the following genes: FSHR, AMH, CYP19, and AR. All samples in which one of the abovementioned parameters was measured were included, but typically multiple parameters were measured. Highly significant differences in concentration and follicular content in relation to follicular diameter were found for all measured hormones despite massive variability in-between follicles for any given diameter. The results demonstrate that profound changes take place in the hormonal microenvironment around follicular diameters of 8-11 mm corresponding to when follicular selection occurs. At this point, inhibin-B and inhibin-A showed distinct peaks concomitant with a significant reduction in both AMH protein and mRNA expression. Concentrations of inhibins, androgens, FSHR, and AR were intimately associated, and it is suggested that inhibin-B in combination with PAPP-A and thereby IGF2 activity exerts important paracrine signaling at follicular selection. At the same time upregulation of estradiol synthesis and CYP19 mRNA expression increased steroid output profoundly. Furthermore, the highly significant association between FSHR and AR mRNA gene expression enforces important functions of androgens in follicular development. Collectively, these data reintroduce the understanding of the follicular phase as two parted in which regulation of steroidogenesis differs. The profound changes taking place around follicular selection highlight important paracrine actions of TGF-β family members and IGFs for securing dominance of the selected follicle.

Treatment with chemotherapy, radiotherapy, or surgery that involves reproductive organs can cause impaired spermatogenesis, testosterone deficiency, and physical sexual dysfunction in male pubertal, adolescent, and young adult cancer survivors. Guidelines for surveillance and management of potential adverse effects could improve cancer survivors' health and quality of life. Surveillance recommendations vary considerably, causing uncertainty about optimum screening practices. This clinical practice guideline recommended by the International Late Effects of Childhood Cancer Guideline Harmonization Group in collaboration with the PanCareSurFup Consortium, developed using evidence-based methodology, critically synthesises surveillance recommendations for gonadotoxicity in male childhood, adolescent, and young adult (CAYA) cancer survivors. The recommendations were developed by an international multidisciplinary panel including 25 experts in relevant medical specialties, using a consistent and transparent process. Recommendations were graded according to the strength of underlying evidence and potential benefit gained by early detection and appropriate management. The aim of the recommendations is to enhance evidence-based care for male CAYA cancer survivors. The guidelines reveal the paucity of high-quality evidence, highlighting the need for further targeted research.

INTRODUCTION Atherosclerosis is a systemic disorder. It is a frequent leading cause of coronary artery disease (CAD). Similarly, atherosclerotic vascular alterations could lead to testicular arterial blood flow reduction and impairment of testicular function with age. Inhibin-B has been validated as a valuable serum marker of testicular functions and its correlation with testicular volume was shown in some studies done before. The purpose of this study is to investigate the association between serum inhibin-B levels and CAD in elderly men. MATERIAL AND METHODS Between March 2009 and March 2010, fifty-two 50-80-year-old consecutive patients with Gensini score over 20 and ejection fraction (EF) > 50% were included in the study as the CAD group. Fifty healthy men without any cardiac disease history were recruited as the control group. All patients in the CAD group who had indications for coronary artery angiography underwent selective coronary artery angiography. RESULTS Inhibin-B, total testosterone and testicular volume levels were found to be significantly lower in the CAD group in comparison with the control group (p = 0.004, p < 0.0001, and p = 0.001 respectively). CONCLUSIONS In this study, although no correlation was found in CAD patients between Gensini score and inhibin-B or testicular volume, inhibin-B levels and testicular volume were significantly lower in patients with CAD than in healthy men. In order to fully assess the relationship between serum inhibin-B levels and CAD, multi-centered prospective and longitudinal studies must be done in elderly male patients.

This work was supported by Scientific Research Projects Coordination Unit of Istanbul University (Project no: 47791)., Objective: Polycystic ovary syndrome (PCOS) is a common endocrine problem in adolescents with an increasing prevalence of 30%. Pursuing new biomarkers with high specificity and sensitivity in the diagnosis of PCOS in adolescents is currently an active area of research. We aimed to investigate the diagnostic value of anti-Mullerian hormone (AMH), insulin-like peptide-3 (INSL3), inhibin-A (INH-A), and inhibin-B (INH-B) in adolescents with PCOS and also to determine the association, if any, between these hormones and clinical/laboratory findings related with hyperandrogenism. Methods: The study group comprised 53 adolescent girls aged between 14.5 and 20 years who were admitted to our outpatient clinic with symptoms of hirsutism and/or irregular menses and diagnosed as having PCOS in accordance with the Rotterdam criteria. Twenty-six healthy peers, eumenorrheic for at least two years and body mass index-matched, constituted the controls. Fasting blood samples for hormones [luteinizing hormone (LH), follicle-stimulating hormone (FSH), dehydroepiandrosterone-sulfate (DHEAS), androstenedione (D4-A), total/free testosterone (T/fT), sex hormone binding globulin (SHBG), AMH, INSL3, INH-A, INH-B] were drawn after an overnight fast. Results: In the PCOS group, 83% of the subjects were oligomenorrheic/amenorrheic and 87% had hirsutism. The LH, LH/FSH ratio, total T, fT, free androgen-index (FAI), DHEAS levels were significantly higher (p=0.005, p=0.042, p=0.047, p0.05), AMH and INH-A levels were found to be significantly higher in the PCOS group compared to the controls (p, Scientific Research Projects Coordination Unit of Istanbul University [47791]

The primary function of the female ovary is the production of a mature and viable oocyte capable of fertilization and subsequent embryo development and implantation. At birth, the ovary contains a finite number of oocytes available for folliculogenesis. This finite number of available oocytes is termed “the ovarian reserve”. The determination of ovarian reserve is important in the assessment and treatment of infertility. As the ovary ages, the ovarian reserve will decline. Infertility affects approximately 15%–20% of reproductive aged couples. The most commonly used biomarker assay to assess ovarian reserve is the measurement of follicle stimulating hormone (FSH) on day 3 of the menstrual cycle. However, anti-müllerian hormone and inhibin-B are other biomarkers of ovarian reserve that are gaining in popularity since they provide direct determination of ovarian status, whereas day 3 FSH is an indirect measurement. This review examines the physical tools and the hormone biomarkers used to evaluate ovarian reserve.

BACKGROUND: Ovarian reserve is related to age and can be estimated by ovarian reserve tests (ORTs), such as antral follicle count (AFC) and various endocrine parameters. The endocrine function of a follicle is related to its size. The aim of this study is to evaluate which sizes of antral follicles are most closely correlated with age and the outcome of endocrine ORTs. METHODS: In total 474 subfertile, ovulatory patients, recruited from two fertility centers in The Netherlands, participated in this prospective cohort study. The following ORTs were performed: AFC (follicles from 2 to 10 mm), basal FSH, basal inhibin B (bInhB), clomiphene citrate challenge test and inhibin B after stimulation with clomiphene citrate. RESULTS: The number of small follicles (2-6 mm) declined with age; the number of larger follicles (7-10 mm) remained constant. Independent of age, the number of small follicles was significantly related to all ORTs (P

For women aged 41-43 years old, success rates in IVF are generally poor. This study aimed to assess cumulative live birth rate related to treatment costs over a maximum of three IVF cycles in selected women who were considered to still have adequate ovarian reserve. Fifty-five patients (38% of the total cohort, n = 144) were excluded from IVF treatment based on low antral follicle count ( 15 IU/l). Of those admitted, 66 (74%) actually started and completed a total of 125 IVF/intracytoplasmic sperm injection cycles. Treatment resulted in 10 live births (8% per cycle). Kaplan-Meier survival analysis revealed a realistic cumulative live birth rate after three cycles of 17%. The direct medical costs per live birth were calculated to be approximately E44,000. These results show that selection towards favourable ovarian reserve status in the female age group 41-43 years yielded disappointing results in terms of cumulative live birth rates after IVF. In view of the costs raised per live birth, improvement of selection parameters for treatment in this age group is warranted.

Objective: To study the association between serum anti-Mullerian hormone (AMH) levels and follicular development and endocrine responses induced by increasing doses (5.2-12.1 mu g/day) of a novel recombinant human FSH (rhFSH, FE 999049) in patients undergoing in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) in a GnRH antagonist protocol. Design: Secondary analysis of a randomized controlled trial with stratified randomization according to AMH (lower stratum: 5.0-14.9 pmol/l; higher stratum: 15.0-44.9 pmol/l). Patients: Infertile women of good prognosis (n = 265). Measurements: Follicular development and endocrine parameters during controlled ovarian stimulation (COS) with rhFSH. Results: Serum FSH levels increased with increasing rhFSH doses and steady-state levels for each dose were similar in both AMH strata. In the whole study population, significant (P < 0.001) positive dose responses were observed for the number of follicles >= 12 mm, and serum levels of oestradiol, inhibin B, inhibin A and progesterone at end of stimulation. In comparison with the higher AMH stratum, patients in the lower AMH stratum had significantly different slopes of the dose-response curves for these hormones, and no clear dose-related increase was observed for the number of follicles in these patients. Conclusions: Dose-response relationships between rhFSH and follicular development and endocrine parameters are significantly different for IVF/ICSI patients with lower and higher serum AMH levels at start of COS.

Background: The global obesity epidemic has paralleled a decrease in semen quality. Yet, the association between obesity and sperm parameters remains controversial. The purpose of this report was to update the evidence on the association between BMI and sperm count through a systematic review with meta-analysis. Methods: A systematic review of available literature (with no language restriction) was performed to investigate the impact of BMI on sperm count. Relevant studies published until June 2012 were identified from a Pubmed and EMBASE search. We also included unpublished data (n ¼ 717 men) obtained from the Infertility Center of Bondy, France. Abstracts of relevant articles were examined and studies that could be included in this review were retrieved. Authors of relevant studies for the meta-analysis were contacted by email and asked to provide standardized data. Results: A total of 21 studies were included in the meta-analysis, resulting in a sample of 13 077 men from the general population and attending fertility clinics. Data were stratified according to the total sperm count as normozoospermia, oligozoospermia and azoospermia. Standardized weighted mean differences in sperm concentration did not differ significantly across BMI categories. There was a J-shaped relationship between BMI categories and risk of oligozoospermia or azoospermia. Compared with men of normal weight, the odds ratio (95% confidence interval) for oligozoospermia or azoospermia was 1.15 (0.93–1.43) for underweight, 1.11 (1.01–1.21) for overweight, 1.28 (1.06– 1.55) for obese and 2.04 (1.59–2.62) for morbidly obese men. Conclusions: Overweight and obesity were associated with an increased prevalence of azoospermia or oligozoospermia. The main limitation of this report is that studied populations varied, with men recruited from both the general population and infertile couples. Whether weight normalization could improve sperm parameters should be evaluated further. Fil: Sermondade, N.. Hôpital Jean Verdier; Francia. Universite de Paris 13-nord; Francia Fil: Faure, C.. Hôpital Jean Verdier; Francia. Universite de Paris 13-nord; Francia Fil: Fezeu, L.. Universite de Paris 13-nord; Francia Fil: Shayeb, A. G.. University Hospital of Wales; Reino Unido Fil: Bonde, J. P.. Bispebjerg Hospital of Copenhagen University; Dinamarca Fil: Jensen, J. K.. University Department of Growth and Reproduction; Dinamarca Fil: Van Wely, M.. Academic Medical Centre; Países Bajos Fil: Cao, J.. Third Military Medical University; China Fil: Martini, Ana Carolina. Universidad Nacional de Córdoba. Facultad de Ciencias Médicas; Argentina. Consejo Nacional de Investigaciones Cientificas y Tecnicas. Centro Cientifico Tecnologico Cordoba. Instituto de Investigaciones en Ciencias de la Salud; Argentina Fil: Eskandar, M.. King Khalid University; Arabia Saudita Fil: Chavarro, J. E.. Harvard University. Harvard School Of Public Health; Estados Unidos. Harvard Medical School; Estados Unidos Fil: Koloszar, S.. University of Szeged; Hungría Fil: Twigt, J. M.. University Medical Center; Países Bajos Fil: Ramlau Hansen, C. H.. Aarhus University; Dinamarca Fil: Borges Jr, E.. Fertility-Assisted Fertilization Center; Brasil Fil: Lotti, F.. Universita Degli Studi Di Firenze; Italia Fil: Steegers Theunissen, R. P. M.. University Medical Center; Países Bajos Fil: Zorn, B.. University Medical Center Ljubljana; Eslovenia Fil: Polotsky, A. J.. University of Colorado Denver; Estados Unidos Fil: La Vignera, S.. University of Catania; Italia Fil: Eskenazi, B.. University Of California Berkeley; Estados Unidos Fil: Tremellen, K.. University of South Australia; Australia Fil: Magnusdottir, E. V.. University of Iceland; Islandia Fil: Fejes, I.. University of Szeged; Hungría Fil: Hercberg, S.. Universite de Paris 13-nord; Francia. Hôpital Avicenne; Francia Fil: Lévy, R.. Hôpital Jean Verdier; Francia. Universite de Paris 13-nord; Francia Fil: Czernichow, S.. University of Versailles Saint Quentin en Yvelines; Francia. Centre for Research in Epidemiology and Population Health; Francia

KISA, Ucler/0000-0002-8131-6810 WOS: 000275991900008 PubMed: 19590975 In the present study, the relationship between serum/seminal plasma and serum FSH and seminal parameters was evaluated in adults and adolescent varicocele patients and compared with normal fertile cases. A total of 50 adult patients with varicocele (Group-1) and 50 adolescents with varicocele (Group-2) were enrolled into the study. Fifty fertile cases without any scrotal pathology were accepted as control group (Group-3). Serum gonadotropin, sex steroids and serum and seminal plasma inhibin-B levels were measured, and semen analysis was performed after 2 and 5 days of sexual abstinence. All parameters were compared among three groups by using one-way ANOVA test. There were statistically significant differences among three groups on seminal parameters due to disturbed spermatogenesis in patients with varicocele (P < 0.05). However, there were not statistical differences between serum and seminal plasma Inhibin-B levels among groups. In varicocele patients, serum inhibin-B levels showed negative and significant correlation only with FSH levels (r = -0.253, P = 0.011). On the contrary, neither serum nor seminal plasma inhibin-B levels showed significant correlation with seminal parameters. While varicocele affects different mechanisms in the regulation of spermatogenesis in testes, serum and seminal plasma inhibin-B have not any role in decreased spermatogenesis in varicocele. Research Found of University of KirikkaleKirikkale University [03/08.03.17] This study was supported by Research Found of University of Kirikkale (03/08.03.17). This study was presented in the 28th Congress of SIU in Cape Town.

Tez (Tıpta Uzmanlık) -- Kırıkkale Üniversitesi 87195 …

For women aged 41-43 years old, success rates in IVF are generally poor. This study aimed to assess cumulative live birth rate related to treatment costs over a maximum of three IVF cycles in selected women who were considered to still have adequate ovarian reserve. Fifty-five patients (38% of the total cohort, n = 144) were excluded from IVF treatment based on low antral follicle count ( 15 IU/l). Of those admitted, 66 (74%) actually started and completed a total of 125 IVF/intracytoplasmic sperm injection cycles. Treatment resulted in 10 live births (8% per cycle). Kaplan-Meier survival analysis revealed a realistic cumulative live birth rate after three cycles of 17%. The direct medical costs per live birth were calculated to be approximately E44,000. These results show that selection towards favourable ovarian reserve status in the female age group 41-43 years yielded disappointing results in terms of cumulative live birth rates after IVF. In view of the costs raised per live birth, improvement of selection parameters for treatment in this age group is warranted.

������������. H ����������������������-�� (Inh-��) ������������������ ������ �������������� Sertoli �������������������� ���� ���������������� �������������������� ������������������ ������ �������������� ������ FSH. �� ���������� ������ Inh-�� ������ �������������������� ������ �������������������������������������������� ������ �������� ������������ ��������������������������. ������������ ������ ���������������� �������� �� �������������������������� ������ �������������� ������ ������ �������� ���������������� ���������������� ������ Inh-�� ���� ���������������������� ������������ ������ ���������������� ���������� ������ �� ������������������ �������� ���� ���� ���������������� ������ FNA ������������. ���������������� ������ ��������������. ���� 67 ���������������������� ������ 29 ���������������� ������������������������ �������������� ������������������ �������������� ������ ���������������� ������������������ Sertoli (EFSERT: �������������������������� ���������������� Inh-�� ������ ������ �������� 24 ������ 48 �������� ������ ���� ���������������� 300 IU rhFSH). ���� 54 ������ �������� ���������������������� ������������ ������������������������ FNA ������������. ������������������������. �������������� �������������������� ������������������ �������������� ������������ ������ �������������������� ������������ ������ ���������������� �������� ���������� ���� ������������ (55,8 �� 51,2 ������������ 115,7 �� 54,0 pg/mL, ��������������������, p < 0,001) �������� ������ ���� �������������������� �������������� Inh-�� (64,6 �� 71,8 ������������ 69,7 �� 23,6 pg/mL, p = ���� �������� 24 �������� ������ 63,3 �� 79,2 ������������ 87,9 �� 25,1 pg/mL, p = ���� �������� 48 ��������). ������������ ������������������ ������������������ ������������ ������ �������������� ���������������� Inh-�� ������ ������ �������������������������� ������ FNA (r =0,475, p, Objective. Inhibin-�� (Inh-��) is produced by Sertoli cells and controls FSH secretion through a negative feedback mechanism. The role of Inh-�� as a diagnostic tool in Male infertility is not fully elucidated. The aim of this study was to investigate the clinical value of basal and stimulated serum Inh-�� levels as a marker of Sertoli cell function and as a predictor of the recovery of sperm in FNA performed in subfertile men. Design. We studied 67 subfertile men through basal hormonal as well as dynamic Sertoli-cell test (EFSERT: serum Inh-�� levels before and 24 h and 48 h after administration of 300 IU rhFSH intramuscularly). Fifty-four of the subfertile men underwent testicular Fine Needle Aspiration (FNA). Twenty-nine young healthy men were used as a control group. Results. There was significant difference between subfertile and control men regarding the basal (55,8 �� 51,2 vs. 115,7 �� 54,0 pg/mL respectively, p < 0,001) but not the stimulated Inh-�� levels (64,6 �� 71,8 vs. 69,7 �� 23,6 pg/mL, p = NS at 24h and 63,3 �� 79,2 vs. 87,9 ��25,1 pg/mL, p = NS at 48h). There was significant correlation between basal Inh-�� levels and FNA findings (r = -0.475, p < 0.01). Area Under Curve in a Receiver Operating Characteristic curve was higher for Inh-�� than FSH (0.725 vs. 0.663 respectively) for prediction of sperm retrieval in a single testicular FNA with a threshold of Inh-�� 54 pg/mL having a sensitivity of 59% and a specificity of 86%. Conducting a stepwise multiple regression analysis setting FNA results as the dependent parameter and mean testicular volume, FSH, T and basal serum Inh-b as the independent parameters, all independent parameters were excluded in the final model with the exception of basal serum Inh-�� levels, which seem to explain only 30% of FNA results (r2 = 0,308, p < 0,001). Conclusion. Basal serum Inh-�� levels seem to constitute an important diagnostic parameter in Male subfertility, as they reflect both Sertoli cell function and testicular cytology better than FSH levels

Background. There has been an apparent decline in sperm density during the last 5 decades in Denmark, a country in which women have among the highest rates of smoking in Europe. We examined semen quality and sex hormones in men in relation to their mothers' tobacco smoking during pregnancy. Methods. Male participants were selected from the population-based Danish Twin Registry and the Danish Civil Registration System as part of a study on hereditary and environmental determinants of semen quality. From November 1999 to May 2000 we collected one fresh semen and blood sample from each of 316 men. Data on prenatal tobacco exposure were obtained for 265 of these men from a questionnaire filled in by their mothers. Results. Adjusting for age, current smoking status and other factors, sperm density was 48% lower (95% confidence interval = -69% to -11) among sons of mothers who smoked more than 10 cigarettes per day during pregnancy. Total sperm counts and levels of inhibin-B were also reduced among this group, whereas follicular stimulating hormone levels were somewhat higher (16% increase; 95% confidence interval = -13% to 54%). These effects were not seen in the lower smoking category (1-10 cigarettes per day). Conclusions. High levels of smoking (>10 cigarettes per day) during pregnancy may be a partial explanation for the apparent secular decline and the geographic differences in sperm counts. Copyright © 2003 by Lippincott Williams & Wilkins, Inc.