Semen analysis was performed according to World Health Organization guidelines. Testicular volume was assessed with the Prader's orchidometer. Serum levels of inhibin B (pg/mL), LH (mIU/mL), FSH (mIU/mL), prolactin (micro IU/mL), and testosterone (nmol/L) were assessed. The mean ± SEM inhibin B and testosterone levels were significantly lower in the patients than in the controls (inhibin B: 116.4 ± 11.7 vs. 181.2 ± 20.9, P=.008; testosterone. Sperm count and testicular volume in the patients were significantly and positively correlated with inhibin B. Inhibin B in the patients was negatively correlated with gonadotropinsand was positively correlated with testosterone.

Editorial Comment:

This somewhat limited study confirms the previously held notion that serum inhibin B levels are significanlty correlated with spermatogensis. However, the authors fail to demonstrate the clinical utility of the Inhibin level as compared to FSH. When FSH levels were normal, inhibin levels added no additional diagnostic value. They note that inhibin levels do correlate with spermatogenesis in varicocele patients whereas FSH did not and hypothesize that inhibin levels may have some predictive value for outcome after varicocelectomy. Clearly inhibin is an important dimeric hormone reflecting spermatogenesis. It measurement has not been demonstrated to effect the treatment of the infertile patient at this time.

Fertility and Sterility Vol 86, No 2 August 2006

Written by Harris M. Nagler, MD, a Contributing Editor with UroToday.

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