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Objectives: The current study estimated the levels of anti mullerian hormone (AMH) and inhibin-B and reproductive hormones in non obstructive azoospermic (NOA) cases and obstructive azoospermic (OA) cases as well as comparing between them as regards the sensitivity and specificity in determining the sperm retrieval hope in the NOA cases. Finally, we analyzed any potential correlation between all the hormones measured in the current study. Methods: The current case control study was conducted at the andrology outpatient clinic from June (2021) to March (2022). The study recruited 135 participants divided equally into three groups NOA cases, OA cases and controls, respectively. Results: The mean inhibin-B was significantly lower in the NOA cases compared to the OA cases and the controls. There was a positive moderate correlation between AMH and Inhibin-B. Also, there was a positive moderate correlation between inhibin-B and free testosterone (FT) and positive weak correlation between beta Inhibin and leutinizing hormone (LH). Conclusions: The current study asserts the observation that inhibin-B is also expressed by Leydig cells as it has demonstrated positive correlations with FT and LH. [ABSTRACT FROM AUTHOR]

Background The severe acute respiratory syndrome coronavirus 2 can affect the hypothalamic-pituitary-gonadal axis (HPG) due to the expression of the angiotensin-converting enzyme 2 receptor. Objectives To assess the prevalence of hypogonadism and Sertoli cell dysfunction in coronavirus disease 2019 (COVID-19) male survivors. Method Male subjects recovered from acute COVID-19 infection were prospectively observed. The primary outcomes included the proportion of hypogonadism, defined biochemically as serum testosterone<230 ng/dL or CFT of<6.4 ng/mL if the total testosterone is between 230–320 ng/m. Sertoli cell dysfunction was defined as inhibin-B level<54.5 pg/mL. Subjects with hypogonadism were followed up at 12 months to assess the recovery of the HPG axis. Results Eighty-three subjects aged≥18 years were evaluated at a median of 120 (±35) days post-recovery. Their mean age was 49.50±12.73 years, and the mean BMI was 26.84±5.62 kg/m2. Low testosterone was detected in 21 (24.71%) and low inhibin-B was detected in 14 (19.71%) out of 71 subjects at 3 months. Subjects with low testosterone were younger, with a mean age of 43.29±12.03 years (P-0.08) and higher BMI (P-0.012). The severity of COVID-19 infection, duration of hospitalization, and other factors were not significantly associated with low testosterone. At 12 months, 18 out of 21 subjects came for follow-up, of which 9 (50%) showed persistently low testosterone, suggestive of hypogonadism. Conclusion Following COVID-19 infection, testosterone levels recovered over time; however, a significant proportion of subjects had low levels at 12-month follow-up. These findings have long-term implications for the management of COVID-19 subjects. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To define cyclic changes in anti-Mollerian hormone (AMH), inhibin-B, and progesterone concentrations and establish statistically valid, population-based clinical reference ranges in queens. ANIMALS: Cyclic queens (fertile, n = 6; infertile, 6) from an institutional breeding colony were blood sampled longitudinally, each for over 2 months, between November 2021 and February 2022, and residual serum samples from intact (n = 205) and ovariohysterectomized (49) queens from clinical submissions were used to establish reference ranges for intact and spayed females. METHODS: AMH and inhibin-B were measured using commercially available ELISAs, progesterone was measured using an inhouse ELISA, and 90% Cls were calculated from these data. RESULTS: AMH and inhibin-B fluctuated in a highly correlated, cyclic pattern in 3 queens that did not ovulate immediately, whereas AMH declined as progesterone increased, indicative of ovulation, which occurred spontaneously early in the sampling period in 3 others; statistically valid reference ranges were established in intact and ovariohysterectomized females. CLINICAL RELEVANCE: Cyclic changes in hormone profiles were defined, providing relevant context for interpreting results in cases seeking to determine gonadal status (presence or absence of gonadal tissue) on the basis of established, population-based reference ranges reported here for cats for the first time. [ABSTRACT FROM AUTHOR]

An 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. We 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. The 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. Orchidopexy 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. [ABSTRACT FROM AUTHOR]

BackgroundSeveral 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.MethodsWe 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.ResultsA 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 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.

Background and Objectives: Undescended testes (UDT) or cryptorchidism is a common congenital disability characterised by the absence of at least one testicle from the scrotum. The primary aim of surgical correction is to preserve fertility potential and prevent complications including trauma, malignancy, hernia and torsion. Often, children, especially in developing countries, present late with UDT. The effect of surgical correction in the recovery of Sertoli cell function in children aged more than 2 years is not apparent. The present study was conducted to study the change in inhibin-B level as a marker of Sertoli cell function in surgically corrected UDT in a heterogeneous population. Materials and Methods: A prospective observational study conducted over a 3-year period at a tertiary care paediatric surgery centre recruited 76 children with UDT undergoing surgical correction. Inhibin-B as a marker for Sertoli cell function was studied preoperatively and postoperatively. Continuous variables were summarised by calculating mean, standard deviation, median and interquartile range (IQR). Quantile versus quantile plotting was done to assess the distribution of the data. Data were analysed in two groups, with participants aged

Background and Objectives: Undescended testes (UDT) or cryptorchidism is a common congenital disability characterised by the absence of at least one testicle from the scrotum. The primary aim of surgical correction is to preserve fertility potential and prevent complications including trauma, malignancy, hernia and torsion. Often, children, especially in developing countries, present late with UDT. The effect of surgical correction in the recovery of Sertoli cell function in children aged more than 2 years is not apparent. The present study was conducted to study the change in inhibin-B level as a marker of Sertoli cell function in surgically corrected UDT in a heterogeneous population.Materials and Methods: A prospective observational study conducted over a 3-year period at a tertiary care paediatric surgery centre recruited 76 children with UDT undergoing surgical correction. Inhibin-B as a marker for Sertoli cell function was studied preoperatively and postoperatively. Continuous variables were summarised by calculating mean, standard deviation, median and interquartile range (IQR). Quantile versus quantile plotting was done to assess the distribution of the data. Data were analysed in two groups, with participants aged <2 years (Group A) and more than 2 years (Group B). Wilcoxon signed-rank test was used to compare the pre-operative and post-operative value.Results: In Group A (n = 39), the median (IQR) of pre-operative inhibin-B was 181 pg/ml (148-254) and post-operative inhibin-B was 230 pg/ml (176-296). In Group B, the median (IQR) of pre-operative inhibin was 70 pg/ml (44-104) and post-operative inhibin was 102 pg/ml (46-176). There was a significant increase in post-operative inhibin when compared to the pre-operative inhibin (P = 0.015 and 0.012, respectively, in Group A and B). Luteinizing hormone (LH) showed a significant decrease (P = 0.002) in Group A following surgery but bordering on significance in Group B (P = 0.43). On the other hand, follicle-stimulating hormone showed a significant decrease (P < 0.01) in Group B following surgery but not in Group A (P = 0.87).Conclusion: The mean post-operative inhibin-B levels were increased significantly as compared to the pre-operative levels indicating either a successful orchiopexy/adequate germ cell number or both. The benefit of orchiopexy may extend even to children presenting late for evaluation. [ABSTRACT FROM AUTHOR]

Objective: To establish statistically valid, population-based reference intervals (RIs) for canine anti-Müllerian hormone (AMH) and define changes in AMH and inhibin-B in bitches during breeding cycles., Methods: A homologous canine ELISA was used to measure AMH in serum samples (collected between May 2019 and July 2024) from 102 intact and 78 reportedly ovariohysterectomized (OVH) bitches and 8 bitches before and after ovariohysterectomy, and in longitudinal samples from 24 bitches undergoing breeding management. Established 95% RIs were used in a retrospective assessment of 3,193 clinical submissions. Cyclic variation of AMH and inhibin-B (heterologous ELISA) were regressed with time and normalized to the rise in progesterone in samples from breeding bitches., Results: Intact and OVH RIs for AMH were calculated with and without inclusion of 7 samples from reportedly OVH bitches that had AMH concentrations in the intact RI. Anti-Müllerian hormone and inhibin-B were positively correlated, and AMH was 3 times higher in proestrus than in estrus. Retrospectively, of 3,193 samples submitted for clinical AMH testing, 41% to 56% were in or above the intact AMH interval, 37% to 44% were within the OVH interval, and < 10% were inconclusive, depending on how RIs were defined., Conclusions: Statistically valid, population-based RIs establish a sound basis for interpreting results of clinical submissions requesting AMH to assess gonadal status in the bitch., Clinical Relevance: Confirmation of cyclic variation in AMH (and, for the first time, inhibin-B) reaffirms proestrus as the optimum time to draw samples, and ≤ 10% of samples submitted for determination of gonadal status are expected to fall in an inconclusive AMH RI.

Inhibins are important ovarian hormones that control the action of the pituitary gonadotropins which regulate the ovarian cycle. The present experiment aims to study the role of steroid-free follicular fluid-antibodies (S-FBFF-ab) on the reproductive hormone levels at estrus and metestrus phases in cycling female rats. Follicular fluid was collected from mature ovarian follicles, centrifuged and treatment with activated charcoal. S-FBFF was isolated and used for immunization of adult male rabbits. After 5 injections, blood was withdrawn for separation of S-FBFF-ab. Eighty mature female rats were assigned into control and treatment groups (40 each). At late metestrus phase, females of the control were injected intra-peritoneally with 100 μL of physiological saline, whereas treated females were injected intra-peritoneally with 100 μL of S-FBFF-ab. At early estrus and early metestrus phases of each estrous cycle, serum concentrations of inhibin-B, follicle stimulating hormone (FSH), estradiol (E2), and prolactin (PRL) were estimated. The results revealed that S-FBFF-ab has inhibin immuno-neutralization effect, which caused elevation in the concentrations of serum FSH and E2, and significant decline of serum PRL and inhibin-B, at early estrus, whereas significant elevation of E2 and PRL, and significant decline of serum FSH, at early metestrus. Furthermore, the results of gene expression revealed a significant elevation of ovarian aromatase gene at both early estrus and early metestrus phases, whereas pituitary PRL gene showed significant decline at early estrus phase and significant elevation at early metestrus phase. In conclusion, passive immunization against S-FBFF could augment the reproductive efficiency through increase reproductive endocrine activity.

Background: 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., Methods: 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., Results: 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., Conclusion: 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., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Gutiérrez, Muñoz-Pérez, Zapater, Mira, Rodríguez, Sempere-Robles, Torregrosa, Alfayate, Moreno-Torres, Bernal, Belén-Galipienso, Cameo, Sirera, Herreros, Bernabeu, Moreno-Pérez and Madero-Velázquez.)

Inhibins are important ovarian hormones that control the action of the pituitary gonadotropins which regulate the ovarian cycle. The present experiment aims to study the role of steroid-free follicular fluid-antibodies (S-FBFF-ab) on the reproductive hormone levels at estrus and metestrus phases in cycling female rats. Follicular fluid was collected from mature ovarian follicles, centrifuged and treatment with activated charcoal. S-FBFF was isolated and used for immunization of adult male rabbits. After 5 injections, blood was withdrawn for separation of S-FBFF-ab. Eighty mature female rats were assigned into control and treatment groups (40 each). At late metestrus phase, females of the control were injected intra-peritoneally with 100 μL of physiological saline, whereas treated females were injected intra-peritoneally with 100 μL of S-FBFF-ab. At early estrus and early metestrus phases of each estrous cycle, serum concentrations of inhibin-B, follicle stimulating hormone (FSH), estradiol (E2), and prolactin (PRL) were estimated. The results revealed that S-FBFF-ab has inhibin immuno-neutralization effect, which caused elevation in the concentrations of serum FSH and E2, and significant decline of serum PRL and inhibin- B, at early estrus, whereas significant elevation of E2 and PRL, and significant decline of serum FSH, at early metestrus. Furthermore, the results of gene expression revealed a significant elevation of ovarian aromatase gene at both early estrus and early metestrus phases, whereas pituitary PRL gene showed significant decline at early estrus phase and significant elevation at early metestrus phase. In conclusion, passive immunization against S-FBFF could augment the reproductive efficiency through increase reproductive endocrine activity. [ABSTRACT FROM AUTHOR]

Purpose: Undescended testes (UDT) are subjected to heat stress, which can disturb gonocyte transformation as well as apoptosis. This study aims to describe the apoptosis pathway occurring during minipuberty of children with unilateral (UDT), and to investigate the role of inhibin-B.Methods: Testicular biopsies at unilateral orchidopexy of 10 boys (6-9 months old) with normal inhibin-B (n = 5) or low inhibin-B (n = 5) were selected for immunohistochemistry and TUNEL (Terminal deoxynucleotidyl transferase dUTP nick end labelling) assay. Testicular tubules were labelled with antibodies against Anti-Müllerian hormone (AMH, Sertoli cell marker), mouse Vasa Homolog (MVH) and placental alkaline phosphatase (PLAP) (both germ cell markers), cleaved caspase3 (apoptotic marker), and followed by confocal imaging and cell counting with Fiji/ImageJ. Data were analyzed with GraphPad Prism.Results: In males with low and normal inhibin-B, there was no statistical difference (p > 0.05) in the percentage of testicular tubules containing TUNEL + cells, number of cleaved caspase3 ± germ cells/tubule, total number of germ cells/tubule, and the percentage of fibrotic tubules or number of Sertoli cells/tubule.Conclusions: These results suggest that inhibin-B does not regulate cell death of gonocytes and further studies are required to uncover any role of inhibin-B in gonocyte transformation. [ABSTRACT FROM AUTHOR]

Introduction: Inhibin-B is glycoproteins of the transforming growth factor-β superfamily, is produced almost exclusively by the Sertoli cells and has been proposed as direct markers of their function and indirect markers of spermatogenesis. Our objective was to evaluate the predictive value of serum Inhibin-B levels as an indicator of the presence of testicular spermatozoa in non-obstructive azoospermia (NOA), compared with other markers such as FSH and testicular volume. Material and methods: A total of 228 patients with idiopathic non-obstructive azoospermia (NOA) were recruited in this prospective study. Inhibin-B in serum has been evaluated before sperm retrieval by Enzyme-Linked Immuno-Sorbent Assay (Elisa), in addition to FSH and testosterone. Testicular volume was measured by sonography. Testicular Fine Needle Aspiration (FNA) and Testicular Sperm Extraction (TESE) were performed for sperm retrieval. The patients were classified according to the presence or absence of Testicular spermatozoa into two groups (I and II respectively). Results: Spermatozoa were retrieved in 87 patients (38.16%), classified as group I and were absent in 141 patients (61.84%) classified as group II. Mean serum Inhibin-B ± SD was significantly higher in group I than in group II, 71.77 versus 27.49 respectively (P

Abstract Purpose A 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. Methods 601 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. Results 501 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). Conclusions All findings could be associated with placental dysfunction with altered human chorionic gonadotropin production well described in women smoking during pregnancy. Type of study Prognosis study (prospective cohort study with > 80% follow-up). Level of evidence Level 1. [ABSTRACT FROM AUTHOR]

Abstract The biological function of inhibin is mediated by two heterodimers, inhibin-A and inhibin-B. The relative importance of inhibin-A and –B in male reproductive function varies considerably across species with inhibin-B predominating in many species, whereas inhibin-A appears relatively more important in rams. Research reported to date in stallions has examined total or immunoreactive (ir) inhibin which does not distinguish the two heterodimers. Therefore, the objective of this study was to characterize changes in inhibin-A and inhibin-B concentrations in stallions: 1) across season for a period of one year, and 2) after downregulation of the hypothalamic-pituitary-gonadal (HPG) axis. In Study one, serum samples were obtained monthly from five stallions for a period of one year. Serum concentrations of inhibin-A, inhibin-B, testosterone and estrone sulfate were determined by ELISA. In Study two, stallions were treated with the GnRH antagonist, acyline (n = 4; 330 mg/kg acyline IM) or vehicle control (n = 4; vehicle alone) every five days for 50 days. Plasma concentrations of inhibin-A and –B were determined by ELISA at Days 0, 6, 12, 22, 37, 59, 80, 87 and 104 after initiation of acyline treatment. Testis volume was determined by ultrasonography at weekly intervals. In Study 1, both inhibin-A and inhibin-B showed seasonal changes in concentration with highest concentrations in increasing day length and lowest concentrations in short day lengths. Inhibin-B (overall mean 107.8 ± 4.1 pg/mL) was present at 4.7-fold higher concentrations in serum than inhibin-A (overall mean 23.0 ± 0.7 pg/mL). In Study 2, plasma concentrations of inhibin-B but not inhibin-A were significantly downregulated by administration of the GnRH antagonist, acyline. When the HPG axis was downregulated by acyline, testis volume was strongly correlated with inhibin-B (r = 0.73; P < 0.05) but not inhibin-A (r = 0.22; P = 0.20). In summary, inhibin-B appears to be the predominant form of inhibin in the stallion which undergoes seasonal regulation along with other reproductive parameters and is co-regulated with other endocrine parameters of the HPG axis. Highlights • Inhibin-B is the major inhibin heterodimer present in stallion blood. • Both inhibin-A and inhibin-B are correlated with photoperiod with seasonal peaks corresponding to long day lengths. • Down-regulation of the pituitary axis with a GnRH antagonist decreased concentrations of inhibin-B but not inhibin-A. • Testis volume was strongly correlated with inhibin-B but not inhibin-A concentrations. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

The present study was aimed to examine the effects of 3-week zinc and melatonin administration on testicular tissue injury and serum Inhibin-B levels caused by unilateral testicular torsion-detorsion in rats. The study was performed on 60 Wistar Albino-type adult male rats. The animals were allocated to 6 groups in equal numbers. 1. Control; 2. Sham; 3. Ischemia-reperfusion; 4. Zinc + ischemia-reperfusion; 5. Melatonin + ischemia-reperfusion; 6. Zinc + melatonin + ischemia-reperfusion. Zinc and melatonin were administered before ischemia-reperfusion at doses of 5 and 3 mg/kg respectively, by intraperitoneal route for a period of 3 weeks. Testicular torsion-detorsion procedures consisted of ischemia for 1 h and then reperfusion for another hour of the left testis. Blood and testicular tissue samples were collected to analyze erythrocyte and tissue GSH and plasma and tissue MDA, Inhibin-B levels. The highest erythrocyte and testis GSH values were found in zinc, melatonin, and zinc + melatonin groups ( p < 0.001). Torsion-detorsion group has significantly lower erythrocyte GSH levels and higher plasma MDA values ( p < 0.001). Serum inhibin-B and spermatogenic activity levels in the torsion-detorsion group were also significantly lower than those in the other groups ( p < 0.001). However, zinc-, melatonin-, and melatonin + zinc-supplemented groups have higher inhibin-B and spermatogenetic activity ( p < 0.001). The results of the study show that zinc, melatonin, and melatonin + zinc administration partially restores the increased oxidative stress, as well as the reduced inhibin-B and spermatogenic activity levels in testes ischemia-reperfusion in rats. Suppressed inhibin-B levels in the testicular tissue may be a marker of oxidative stress. [ABSTRACT FROM AUTHOR]

Introduction: Inhibin-B is glycoproteins of the transforming growth factor-b superfamily, is produced almost exclusively by the Sertoli cells and has been proposed as direct markers of their function and indirect markers of spermatogenesis. Our objective was to evaluate the predictive value of serum Inhibin-B levels as an indicator of the presence of testicular spermatozoa in nonobstructive azoospermia (NOA), compared with other markers such as FSH and testicular volume. Material and methods: A total of 228 patients with idiopathic non-obstructive azoospermia (NOA) were recruited in this prospective study. Inhibin-B in serum has been evaluated before sperm retrieval by Enzyme-Linked Immuno-Sorbent Assay (Elisa), in addition to FSH and testosterone. Testicular volume was measured by sonography. Testicular Fine Needle Aspiration (FNA) and Testicular Sperm Extraction (TESE) were performed for sperm retrieval. The patients were classified according to the presence or absence of Testicular spermatozoa into two groups (I and II respectively). Results: Spermatozoa were retrieved in 87 patients (38.16%), classified as group I and were absent in 141 patients (61.84%) classified as group II. Mean serum Inhibin-B ±SD was significantly higher in group I than in group II, 71.77 versus 27.49 respectively (P < 0.001). The odds ratio of Inhibin-B for success of sperm retrieval was 1.0409 (95% CI: 1.0286-1.0533). Serum Inhibin-B demonstrated that the best inhibin-B value threshold for discriminating between successful and failed sperm retrieval was 35 pg/ml, with a sensitivity of 75.86 (95% Confidence interval [CI]: 65.5-84.4) and specificity of 80.85 (CI: 73.4-87.0) for the prediction of the presence of testicular spermatozoa as determined by the receiver operating characteristic (ROC) curve analysis and area under curve (AUC). Conclusions: Inhibin-B might be a predictive marker of persistent spermatogenesis in the men with non-obstructive azoospermia. [ABSTRACT FROM AUTHOR]

Objective To observe the effect of transplantation of human umbilical cord mesenchymal stem cells (hUCMSCs) through tail veins on the levels of luteinizing hormone (LH) and inhibin-B (INHB) in the perimenopausal rats. Methods Thirty natural aging perimenopausal rats (12-14 months old) were randomly divided into the group A and group B, with 15 in each group, which were injected with PBS and hUCMSCs (1 x106 /mL) 1 mL, once every other day, for twice. Fifteen young female rats (3 -5 months old) were set as the group C without treatment. Serum level of LH and INHB were detected before transplantation and at week 2, 3, and 4 after transplantation. Results Before transplantation, the serum LH levels were higher, and the INHB levels were lower in the group A and group B than in the group C (all P < 0. 05); there was no significant difference between groups A and B. After transplantation, no significant difference in the level of LH and INHB between the group A and group C; the serum LH decreased and serum INHB increased in the group B as compared with that before transplantation (P < 0. 05). In the group B, the level of serum LH was lower than that in group A and was higher than that in the group C at the same time; in the group B, serum INHB level was higher than that in the group A and was lower than that in the group Cat the same time (all P <0. 05). Conclusions After hUCMSCs are transplanted into the menopausal rats, it can reduce the serum LH, increase INHB, and improve ovarian function. [ABSTRACT FROM AUTHOR]

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, antimüllerian 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.

Despite early surgery, many boys with bilateral cryptorchidism at surgery have a reduced number of germ cells per tubular cross-section (G/T) in testicular biopsies and/or low inhibin-B with no elevated follicle-stimulating hormone (FSH) as expected based on a normal gonadotropin feed-back mechanism. Such boys have a high risk of later infertility because of insufficient gonadotropin stimulation and may benefit from adjuvant hormonal treatment. Testicular biopsies are not always wanted or accepted. The study aim was to investigate the value of a low inhibin-B and normal FSH to identify patients that might benefit from adjuvant hormonal treatment avoiding the need for testicular biopsy. A series of boys with cryptorchidism were evaluated with serum levels of inhibin-B and FSH in relation to G/T in testicular biopsies, which were compared to previously published age-matched normal control values. A total of 365 boys who underwent bilateral orchidopexy between 0.4 and 7.8 (median: 2) years of age were included. Twenty-seven (7%) patients had increased FSH and low G/T, whereas 11 of these also had low inhibin-B indicating hypergonadotropic hypogonadism. Moreover, 85 (23%) patients between 0.75 and 7.5 (median: 2) years of age had both low G/T (median: 0.3) and low inhibin-B (median: 56 pg/ml) but normal FSH (median: 0.6 U/l) indicating a gonadotropin insufficiency. Three patients with normal FSH and low inhibin B had normal G/T. Our study shows that if surgeons prefer to avoid testicular biopsies and only wish to rely on hormonal parameters (low inhibin-B and normal FSH) in order to diagnose a gonadotropin insufficiency as the cause of hypogonadism, they will identify only about 30% of such cases and overlook about 70% of patients sharing the same endocrinopathy. In addition, if surgeons treat patients for gonadotropin insufficiency only based on low inhibin-B and normal FSH they will solely treat patients with gonadotropin insufficiency and would not overtreat patients. Adjuvant hormonal treatment was indicated by a gonadotropin insufficiency discerned in 23% of boys with bilateral cryptorchidism. Without histology, the clinicians are left with more difficult clinical judgments to identify patients for adjuvant hormonal treatment. The positive predictive value of low inhibin-B and normal FSH corroborated by low G/T was 0.97 (85/85 + 3), but the sensitivity was low (0.30). [Display omitted] [ABSTRACT FROM AUTHOR]

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-Müllerian 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, p<0.001, p=0.007, p=0.014, respectively) and SHBG was significantly lower (p=0.004) in PCOS patients as compared to the controls. Although the INSL-3 and INH-B levels showed no difference between the groups (p>0.05), AMH and INH-A levels were found to be significantly higher in the PCOS group compared to the controls (p<0.001, p<0.001, respectively). In multiple linear regression analysis, WC SDS (p=0.028), logD4-A (p=0.033), logSHBG (p=0.031), and total ovarian volume (p=0.045) had significant effects on AMH levels, and LH (p=0.003) on INH-A levels. In receiver-operating characteristic analysis, the cut-off values for AMH and INH-A were 6.1 ng/mL (sensitivity 81.1%) and 12.8 pg/mL (sensitivity 86.8%), respectively, to diagnose PCOS. When AMH and INH-A were used in combination, the sensitivity (96.2%) increased. Conclusion: INSL3 and INH-B were not found to have diagnostic value in adolescents with PCOS. On the other hand, it was shown that INH-A could be used as a new diagnostic biomarker in addition to AMH. [ABSTRACT FROM AUTHOR]

Purpose of this retrospective study was to investigate if serum markers, men’s age, interval since vasectomy, BMI, testicular size and smoking could predict the success of epididymal or testicular sperm aspiration (PESA/TESA) in vasectomized men. Forty-four consecutively performed PESA/TESA procedures were reviewed retrospectively. Motile sperm was retrieved from 77.3% of PESA/TESA procedures. Mean serum Inhibin-B (Inh-B) level tended to be higher in men who had motile sperm retrieved compared to those who had not (180.3 versus 126.2 pg/ml,p = 0.05). Univariate analysis identified serum Inh-B to be the only predictor of PESA/TESA success (r = 0.32, CI: 0.006–0.584,p = 0.046). Serum FSH, LH, T levels, age, BMI, smoking status and interval since vasectomy did not correlate with the PESA/TESA outcome. Inh-B could modestly discriminate between successful and unsuccessful PESA/TESA (AUC= 0.70) with high positive (89.5%) but low negative prediction (36.8%); 58.6% sensitivity and 77.7% specificity at the optimum cut-off level of 166 pg/ml. Positive outcome was only 50% when the Inh-B level was below 100 pg/ml. It is concluded that a high serum Inh-B might reliably predict successful PESA/TESA in vasectomized men. More invasive sperm retrieval procedures could be reserved for men with very low Inh-B or failed PESA/TESA. Future studies with adequate power may confirm our findings. [ABSTRACT FROM AUTHOR]

Objectives Inhibin 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. Methods A 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. Results The 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. Conclusions Global 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. [ABSTRACT FROM AUTHOR]

Objectives and hypotheses The Sertoli-cells produce inhibin-B and Anti-Müllerian-Hormone (AMH). Much is still unknown about these hormones in prepubertal cryptorchids. The Sertoli-cells are mandatory for germ cell development. The aim of the study was to investigate if there are differences in secretion pattern of Sertoli-cell hormones and their gonadotropin feed-back mechanisms. Methods Included were 94 prepubertal cryptorchid boys 0.5–13.1 years with measurements of serum-inhibin-B, Anti-Müllerian-Hormone (AMH), Luteinizing Hormone (LH) and Follicle Stimulation Hormone (FSH). The serum values were measured using commercially available kits. The hormonal values were related to age-matched normal values. Testicular biopsy was taken at orchiopexy. Results Inhibin-B positively correlated to AMH for 1–13 year-old patients (p < 0.0001), but not for 0.5–1 year-old patients (p = 0.439). For 0.5–1 year-old patients inhibin-B-values tended to decrease (p = 0.055), in contrast to AMH-values (p = 0.852). LH was elevated more often than FSH (p = 0.014). FSH and LH were positively associated in patients both 0.5–1 year (p = 0.042) and 1–13 years of age (p < 0.0001). LH correlated positively to inhibin- B (p = 0.001). In contrast, FSH did not correlate to inhibin-B or AMH (p = 0.755 and p = 0.528). The number of A-dark spermatogonia per tubular transverse section was positively correlated to inhibin-B serum level. Conclusion Our new finding of an association between LH and inhibin-B in infancy of cryptorchid boys may be essential for the transformation of gonocytes to A-dark spermatogonia. Previously, LH associated to inhibin-B was described in early puberty only. During the first year of life inhibin-B values decreased faster than AMH. The AMH-levels may just reflect the increased Sertoli cell number that occurs during the first 3 months of life. [ABSTRACT FROM AUTHOR]

Abstract: Objective: To clarify the modulatory effects of daily consumption of pomegranate extract (PE), olive oil (OO) and Nagilla sativa oil (NSO) on antioxidant activity, sperm quality and pituitary-testicular axis of adult male wistar rats. Methods: Thirty-two adult male Wistar rats were divided into four equal groups, eight rats each. Using rat gastric tubes, 1.0 mL distilled water, 1.0 mL PE, 0.4 mL NSO and 0.4 mL OO were orally administered daily for 6 weeks in the first, second, third and fourth groups, respectively. Reproductive organs, body weight, sperm criteria, testosterone, FSH, LH, inhibin-B, lipid peroxidation, and antioxidant enzyme activities were investigated. At the end of the study protocol, analyses occurred at the same time. Data were analysed by ANOVA test and P<0.05 was considered to be a significant value. Results: In all studied groups, malondialdehyde level was significantly decreased accompanied with an increases in glutathione peroxidase and glutathione. Rats treated with PE showed an increase in catalase activities accompanied with an increase in sperm concentration which was also observed in NSO group. In PE treated group, sperm motility was also increased accompanied with decreased abnormal sperm rate. NSO, OO and PE treated groups shows an insignificant effect on testosterone, inhibin-B, FSH and LH in comparison with control group. Conclusions: These results show that administration of PE, NSO and OO could modify sperm characteristics and antioxidant activity of adult male wistar rats. [Copyright &y& Elsevier]

Abstract: Objective: To compare follicular fluid concentrations of IGF-I, IGF-II, IGFBP-3, inhibin-B, VEGF, and AMH in women undergoing controlled ovarian hyperstimulation with a long-luteal GnRH agonist protocol or multiple-dose GnRH antagonist protocol. Study design: A total of 80 cycles were included; long-luteal GnRH agonist group (n =40) and multiple dose GnRH antagonist group (n =40). All follicular fluid samples were obtained from mature follicles during oocyte retrieval. IGF-I and IGFBP-3 concentrations were measured by immunoradiometric assay. IGF-II, VEGF, AMH, and inhibin-B concentrations were measured by enzyme-linked immunosorbent assay. Results: There were no significant differences in the concentrations of the studied follicular fluid markers, cycle parameters, and treatment outcomes between GnRH agonist and GnRH antagonist protocols. Conclusions: The long-luteal GnRH agonist protocol and multiple-dose GnRH antagonist protocol seem to have similar effects on the follicular microenvironment in women undergoing controlled ovarian hyperstimulation. [Copyright &y& Elsevier]

Objective: The aim of this article is to summarize the recommended updates to the 2001 Stages of Reproductive Aging Workshop (STRAW) criteria. The 2011 STRAW + 10 reviewed advances in understanding of the critical changes in hypothalamic-pituitary-ovarian function that occur before and after the final menstrual period. Method(s): Scientists from five countries and multiple disciplines evaluated data from cohort studies of midlife women and in the context of chronic illness and endocrine disorders on change in menstrual, endocrine, and ovarian markers of reproductive aging including antimüllerian hormone, inhibin-B, follicle-stimulating hormone, and antral follicle count. Modifications were adopted by consensus. Result(s): STRAW + 10 simplified bleeding criteria for the early and late menopausal transition, recommended modifications to criteria for the late reproductive stage (Stage −3) and the early postmenopause stage (Stage +1), provided information on the duration of the late transition (Stage −1) and early postmenopause (Stage +1), and recommended application regardless of women''s age, ethnicity, body size, or lifestyle characteristics. Conclusion(s): STRAW + 10 provides a more comprehensive basis for assessing reproductive aging in research and clinical contexts. Application of the STRAW + 10 staging system should improve comparability of studies of midlife women and facilitate clinical decision making. Nonetheless, important knowledge gaps persist, and seven research priorities are identified. [Copyright &y& Elsevier]

Objective The aim of this article is to summarize the recommended updates to the 2001 Stages of Reproductive Aging Workshop (STRAW) criteria. The 2011 STRAW ++10 reviewed advances in understanding of the critical changes in hypothalamic-pituitary-ovarian function that occur before and after the final menstrual period. Methods Scientists from five countries and multiple disciplines evaluated data from cohort studies of midlife women and in the context of chronic illness and endocrine disorders on change in menstrual, endocrine, and ovarian markers of reproductive aging including antimüllerian hormone, inhibin-B, follicle-stimulating hormone, and antral follicle count. Modifications were adopted by consensus. Results STRAW ++10 simplified bleeding criteria for the early and late menopausal transition, recommended modifications to criteria for the late reproductive stage (Stage −3) and the early postmenopause stage (Stage ++1), provided information on the duration of the late transition (Stage −1) and early postmenopause (Stage ++1), and recommended application regardless of women's age, ethnicity, body size, or lifestyle characteristics. Conclusions STRAW ++10 provides a more comprehensive basis for assessing reproductive aging in research and clinical contexts. Application of the STRAW ++10 staging system should improve comparability of studies of midlife women and facilitate clinical decision making. Nonetheless, important knowledge gaps persist, and seven research priorities are identified. [ABSTRACT FROM AUTHOR]

A case–cohort study of 2,157 patients, aged 17–67 years was performed to assess the impact of body mass index and age on male fertility. Using a multiple regression analysis across the total cohort, only age correlated significantly with all spermiogram parameters and serum hormones, but in patients aged 20–30 years (n = 617) the total sperm count was significantly negatively correlated with body mass index. [ABSTRACT FROM AUTHOR]

Objective: To describe associations between serum inhibin-b and sperm counts, adjusted for effect of time of blood sampling, in larger cohorts than have been previously reported.Design: Cross-sectional studies of spermatogenesis markers.Setting: Four European and four US centers.Patient(s): Fertile men (1,797) were included and examined from October 1996-February 2005.Intervention(s): The study was observational and therefore without any intervention.Main Outcome Measure(s): Associations between inhibin-b and semen variables controlled for time of blood sampling and other covariates.Result(s): Inhibin-b decreased about 2.00% per hour from 8 am-12 pm and then about 3.25% per hour from 12 pm-4 pm. There was a strong positive association between inhibin-b levels less than 150 pg/mL and both sperm concentration and total sperm count (slopes of the regression lines were β=0.011 and β=0.013 for natural logarithm-transformed sperm concentration and total sperm count, respectively). For inhibin-b levels of 150-300 pg/mL the associations were not as steep (β=0.002), but still significant. For inhibin-b levels more than 300 pg/mL there was little association to the sperm counts. Neither sperm motility nor morphology was significantly related to inhibin-b level in any group.Conclusion(s): Serum inhibin-b levels decrease nonlinearly during the daytime, and are positively correlated with sperm counts, but the predictive power is best when inhibin-b is low. [ABSTRACT FROM AUTHOR]

BACKGROUND: The aim of the present study was to determine the intrafollicular concentrations of anti-Müllerian hormone (AMH), inhibin-B and steroids in normal human small antral follicles and to relate them to follicular size. [ABSTRACT FROM PUBLISHER]

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. [ABSTRACT FROM AUTHOR]

Azoospermia can be either of obstructive ctiology or due to the testis' failure to initiate or maintain spermatogenesis. FSH acts through its receptor at Sertoli cell level and modulates spermatogenesis initiation and maintenance. Inhibin B is a Sertoli cell product expressing the functional capacity of the cell and in an indirect way the state of seminiferous tubule activity. Both FSH and inhibin B differentiate clearly testicular from extra-testicular pathology of azoospermia while, none of these hormones has been convincingly established as predictory index for the finding of spermatozoa in TESE. [ABSTRACT FROM AUTHOR]

Objective: To evaluate whether the follicular fluid concentrations of anti-müllerian hormone (AMH), inhibin-B, and P become affected by androgen priming before controlled ovarian hyperstimulation and IVF/intracytoplasmic sperm injection (ICSI) treatment, extending our previous study. Design: Prospective nonrandomized clinical study. Setting: University hospital. Patient(s): Patients (N = 45) undergoing IVF/ICSI treatment received androgen priming before controlled ovarian hyperstimulation. Intervention(s): All patients received cetrorelix, 3 mg SC, on cycle day 2 and 5. Group I (n = 15) received no other pretreatment. Group II (n = 15) received 2.5 mg once daily of letrozole from cycle day 2 through 8. Group III (n = 15) received letrozole as group II plus 1,250 IU hCG on cycle day 2. Main Outcome Measure(s): Follicular fluid concentrations of AMH, inhibin-B, and steroids. Result(s): Follicular fluid concentrations of AMH were significantly higher in group III than in groups I and II (2.6 ± 0.3 vs. 1.6 ± 0.2 and 1.5 ± 0.4 ng/mL. Concentrations of inhibin-B were significantly lower in group II and III as compared with group I (27 ± 4, 27 ± 3 versus 46 ± 6 ng/mL, respectively). Follicular fluid P concentrations remained similar in all groups. Conclusion(s): Granulosa cell production of AMH was significantly augmented and inhibin-B production was significantly reduced by a highly specific pharmacologically induced increase in the intrafollicular androgen levels, suggesting a dual action of androgen on follicular growth and development. [Copyright &y& Elsevier]

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, antimüllerian 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. [ABSTRACT FROM AUTHOR]

We have evaluated the best method to assess the ovarian reserve and the ovarian protective effect of GnRH-analog (GnRH-a), in 29 women with Hodgkin's disease (HD) treated with chemotherapy (CHT). The ovarian reserve was studied by measuring the serum levels of follicle stimulating hormone (FSH), luteinizing hormone (LH), inhibin B, antimullerian hormone (AMH) and the ultrasound antral follicular count (AFC). The patients were randomly treated with or without GnRH-a. At the time of study menstrual function was normal in 21 cases (72.4%), but absent in 8 (27.5%). Mean basal values of FSH, LH, AMH, inhibin B and AFC were normal in patients less than 30 years old and in the group treated four years or less before observation. AFC appeared to be the best marker of reduced ovarian reserve and a combination of AFC-AMH or inhibin B appeared the best predictor. In the GnRH-a group, no women had amenorrhoea, although ovarian reserve assessment was not significantly different from those who were not treated. The time-interval from CHT was the only significant predictor of ovarian function in GnRH-a treated patients. In conclusion, ovarian reserve evaluation, in young patients treated by CHT, can be performed by AFC. GnRH-a treatment does not have a protective effect, but could delay the development of ovarian failure. [ABSTRACT FROM AUTHOR]

Determination of sperm DNA fragmentation, as assessed by the sperm chromatin structure assay (SCSA), has become an important tool for the evaluation of semen quality. The aim of the present study was to describe the biological variation of sperm DNA fragmentation in men attending an andrology clinic and to identify clinical correlates of the biological variation of sperm DNA fragmentation. For this study, two consecutive semen samples from 100 patients attending our andrology outpatient clinic were subjected to semen analysis, performed in parallel according to WHO guidelines and by SCSA. A good agreement between pairs of samples was found for SCSA-derived variables, as indicated by a significantly lower median coefficient of variation (CV) of the DNA Fragmentation Index (DFI) and the high DNA stainability (HDS) compared with WHO semen parameters. In half of the men attending our andrology clinic, however, the individual biological variation of DFI and HDS, expressed as CV of two samples, exceeded 10%. Dysregulation of spermatogenesis, as seen as testicular insufficiency or varicocele, was not associated with increased variability of DFI or HDS. A backward multiple linear regression analysis, however, indicated that the biological variation of DFI may be more profound in men with characteristics of normal spermatogenesis. In conclusion, we confirm previous reports that sperm DNA fragmentation has a lower biological variability than classical semen parameters. We hypothesize that the sperm chromatin structure may be more influenced in patients with normal spermatogenesis, whereas in men with disturbed spermatogenesis, the chromatin structure may be already so impaired that the effect of unidentified factors leading to variability of sperm DNA fragmentation in time may not be as profound. [ABSTRACT FROM AUTHOR]

Abstract: Objective: Our objective was to test the hypothesis that shortening the hormone-free interval (HFI) between cycles of 21 days of oral contraceptives (OCs) reduces pituitary secretion of gonadotropins and ovarian production of estradiol and inhibin-B. Design: We used a prospective trial design comparing the standard 7-day HFI and shortened HFI during cycles, with an OC containing 0.03 mg of ethinyl estradiol and 3 mg of drospirenone. Methods: Twelve current OC users initially utilized an OC in the standard fashion, with 21 days of active pills and a 7-day HFI, followed by 21 days of active pills with randomization to either a 3-day or a 4-day HFI. Nine daily blood samples were obtained for the measurement of follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol and inhibin-B, beginning with active pill 21 days before each HFI of the two cycles. Analysis of variance was used to compare hormones for 9 days bracketing the standard 7-day HFI and to compare, within individuals, the 7-day HFI and the subsequent shortened HFI. Results: During the 7-day HFI, all four hormones significantly (p>.001) increased from baseline. FSH increased beginning on HFI Day 4, inhibin-B increased beginning on HFI Day 5, and LH and estradiol increased beginning on HFI Day 6. Subjects randomized to the 3-day or the 4-day HFI did not differ with regard to age and body size (p=.88) or initial hormone level (p=.67). Greater pituitary and ovarian suppression was seen with the shortened HFI for all four hormones (p<.001). Hormone levels in the 7 days after the last active pill of the second cycle did not differ (p>.4) between the 3-day and the 4-day HFI groups. Conclusions: Shortening the HFI from 7 days to 3 or 4 days blunts increases in the pituitary–ovarian axis during cycles of OC use. [Copyright &y& Elsevier]

Abstract: Objectives:: The aim of this study was to investigate the relationships between the levels of gonadotrophins, estradiol, inhibin-b and bone mass and turn-over in regularly menstruating women aged 35–50 years. Methods:: The study group included 87 healthy volunteers from the community aged 35–50 years. Bone mineral density of lumbar vertebras, wards triangle, throchanter, femur neck, bone resorption and formation markers were studied as well as the serum levels of gonadotrophins, estradiol and inhibin-b on the day 3 of menstrual cycle. Results:: The gonadotrophin levels showed significant positive relation with age, whereas inhibin-b and estradiol levels showed significant negative correlation with age. The gonadotrophins and estradiol levels had no significant association with bone mass and bone formation markers. Increased gonadotrophin (p <0.001) levels and decreased inhibin-b (p <0.01) levels independent from age were correlated with increased bone resorption. Gonadotrophins, estradiol, age, inhibin-b, body mass index (BMI) were the confounding factors for bone resorption (p =0.015, R 2 =0.190) and lumbar bone mass (p =0.041, R 2 =0.148). Multivariate analysis showed an independent contribution of inhibin-b and BMI in the prediction of lumbar bone mass. Conclusion:: This findings suggested that estradiol was not the only factor responsible for bone loss and decrease in reproductive function because increased gonadotrophins and decreased inhibin-b levels might trigger some changes in bone metabolism prior to the menopause. [Copyright &y& Elsevier]

Aim: The value of serum inhibin-B as a predictor of the presence of testicular spermatozoa is still controversial. The purpose of this study is to evaluate the predictive value of the seminal plasma inhibin-B level, which might more directly reflect the secretion by Sertoli cells, and to discriminate between successful and failed testicular sperm extraction (TESE) in non-obstructive azoospermia. Methods: Sixty-two patients with non-obstructive azoospermia were examined at the Department of Obstetrics and Gynecology at Niigata University Hospital, Niigata, Japan. The level of inhibin-B was measured using a two-site enzyme-linked immunoassay. Results: Testicular sperm were successfully retrieved in 17 of 62 patients (27.4%). The serum levels of follicle-stimulating hormone (FSH) were significantly lower and the serum and seminal inhibin-B concentrations were significantly higher in the successful TESE group compared with the failed TESE group. According to the receiver operating characteristics (ROC) curve analysis, the best discriminating seminal plasma inhibin-B level was 27.0 pg/mL (sensitivity 88.2%, specificity 93.3%). The best discriminating serum inhibin-B level was 34.0 pg/mL (sensitivity 70.6%, specificity 95.6%). The area under the ROC curve for seminal plasma inhibin-B was significantly larger than that for FSH and testicular volume. Using multivariate logistic regression analysis, only seminal plasma inhibin-B was an independent predictor of the presence of spermatozoa on TESE. Conclusion: Seminal plasma inhibin-B level is a useful predictor of the presence of testicular sperm in men with non-obstructive azoospermia. [ABSTRACT FROM AUTHOR]

Background: The objective of this study was to determine the prognostic value of the basal estradiol (E2) and inhibin-B levels, the antral follicle count (AFC), and the clomiphene citrate challenge test (CCCT) of ovarian response in controlled ovarian hyperstimulation (COH), in an outcome with normal follicle-stimulating hormone (FSH) concentration in the early follicular phase of the menstrual cycle. Methods: Fifty-two patients undergoing IVF treatment were included in the study. Blood samples were collected for assessment of basal E2, FSH, and inhibin-B levels. Transvaginal ultrasound of an unstimulated cycle was performed to determine the mean antral follicle count (AFC). Serum FSH concentration was measured again on day 10 for CCCT performance. Results: The mean values of women's age, and basal and day 10 FSH levels were significantly higher in cancelled cycles than in the control group, whereas basal inhibin-B and AFC were significantly higher in the latter. The mean basal E2 concentration was similar in both groups. The results from the logistic regression analysis show that CCCT (cut-off point FSH > 12.5 mIU/ml; AUCROC = 0.90) was a better single predictor of poor ovarian response than AFC (AUCROC = 0.85) and inhibin-B (AUCROC = 0.79) with a correct prediction for CCCT (86.5%), antral follicle count (84.6%), and for inhibin-B (82.7%). Conclusions: In women with normal basal FSH level, the determination of E2 has no prognostic value for the outcome of poor responders. However, CCCT, AFC, and inhibin-B tests, when applied separately, produce good prognostic values. CCCT is the best single predictor of poor ovarian response, followed by antral follicle count and basal inhibin-B values. In spite of that, CCCT does not add significantly to the simpler AFC ultrasound test in the prediction of poor ovarian response. [ABSTRACT FROM AUTHOR]

The objective of the study was to compare a standard clomiphene citrate challenge test with inhibin-B serum concentrations also obtained on cycle days 3 and 10 as a negative predictor of pregnancy in a group of 106 women at risk for compromised ovarian function. Mean duration of follow-up was 8.25 months in 95 patients with 30 pregnancies recorded (plus one biochemical). Inhibin-B concentrations on cycle days 3 and 10 were correlated only with each other and not with serum oestradiol, follicle stimulating hormone (FSH) and/or pregnancy rates. Pregnancy occurred in 34.5% (10/29) of all patients with inhibin-B values ≥45 pg/ml on cycle day 3 and in 31.8% (21/66) of those with values <45 pg/ml. For FSH >11 mIU/ml on either day, pregnancy rate was 13.6% versus 38.4% for FSH of ≤9 mIU/ml (P = 0.03). This study reconfirmed the usefulness of a clomiphene citrate challenge test as an indication of ovarian reserve but failed to find clinical value for inhibin-B testing. [ABSTRACT FROM PUBLISHER]