Андрология и генитальная хирургия. 2015; 16: 8-12
Прогностическая значимость ингибина В у инфертильных больных (обзор литературы)
https://doi.org/10.17650/2070-9781-2015-1-8-12Аннотация
Бесплодие является полиэтиологическим заболеванием и требует современных универсальных маркеров, изучение уровня которых позволяло бы определить соответствующую тактику ведения пациентов с нарушением фертильности, оценку прогноза и перспективность лечения. Кроме того, существует явная тенденция к расширению показаний к применению вспомогательных репродуктивных технологий в лечении пациентов с наиболее тяжелыми факторами мужского бесплодия. В качестве одного из таких маркеров, позволяющего судить о морфофункциональном состоянии паренхимы яичка, может выступать ингибин – гормон, состоящий из двух субъединиц. Ингибин В, который вырабатывается клетками Сертоли, а также молодыми сперматогенными клетками в семенных канальцах, является известным эндокринным маркером для оценки сперматогенеза. В обзоре проанализированы результаты исследований, изучающих ценность определения уровня ингибина В при диагностике мужского бесплодия, а также при прогнозировании результатов тестикулярной экстракции спермы. Показано, что в целом ингибин В является более чувствительным маркером, чем фолликулостимулирующий гормон. По мнению ряда авторов, ингибин В благодаря высокой чувствительности и специфичности в будущем может стать альтернативой биопсии яичка, а также маркером дифференциальной диагностики мужского бесплодия. Но в то же время сывороточный уровень ингибина В не может быть использован в качестве единичного маркера у мужчин с необструктивной азооспермией. Неоднозначные полученные результаты требуют дальнейших исследований.
Список литературы
1. European Association of Urology. Guidelines. 2012; 2014.
2. Божедомов В.А., Рохликов И.М., Третьяков А.А. и др. Актуальные вопросы оказания помощи парам с мужским фактором бездетного брака: клинические и организационно-методические аспекты. Андрология и генитальная хирургия 2013;(4):7–16. [Bozhedomov V.A., Rokhlikov I.M., Tretyakov A.A. et al. Topical problems of care rendered to childless couples with male factor infertility: clinical, organizational, and methodical aspects. Andrologiya i genital,naya khirurgia = Andrology and Genital Surgery 2013;(4): 7–16. (In Russ.)].
3. Быков В.Л. Сперматогенез у мужчин в конце XX века. Проблемы репродукции 2000;(1):6–13. [Bykov V.L. Spermatogenesis of males in late XX century. Problemy reproduktsii = Problems of Reproduction 2013;(4):7–16. (In Russ.)].
4. Krause W., Bohring C. Inhibin B as a marker of spermatogenesis. A new dimension in andrology. Hautarzt 2002;53(1):5–10.
5. Dong Z.Y., Yu H., Xiu H.M. et al. Expression of inhibin B subunits in the testicular tissues of azoospermia patients with different pathological alterations. Zhonghua Nan Ke Xue 2008;14(1):20–2.
6. Tyrrell J.B., Findling J.W., Aron D.C. Hypothalamus and pituitary. In: F.S. Greenspan, J.D. Baxter (eds.). Basic and clinical endocrinology. 4th ed. NY: Appleton and Lange, 1994. Pp. 64–127.
7. Anawalt B. D, Bebb R.A., Matsumoto A.M. et al. Serum inhibin B level reflect Sertoli cell function in normal men and men with testicular dysfunction. J Clin Endocrinol Metab 1996;81(9):3341–5.
8. Manzoor S.M., Sattar A., Hashim R. et al. Serum inhibin B as a diagnostic marker of male infertility. J Ayub Med Coll Abbottabad 2012;24(3–4):113–6.
9. Grunewald S., Glander H.J., Paasch U., Kratzsch J. Age-dependent inhibin B concentration in relation to FSH and semen sample qualities: a study in 2448 men. Reproduction 2013;145(3):237–44.
10. Anderson A.M., Muller J., Skakkebaek N.E. Different roles of prepubertal and postpubertal germ cells and Sertoli cells in the regulation of serum inhibin B levels. J Clin Endocrinol Metab 1998;83(12):4451–8.
11. Pierik F.H., Vreeburg J.T. M., Stijnen T. et al. Serum inhibin B as a marker of spermatogenesis. J Clin Endocrinol Metab 1998;83(9):3110–4.
12. Datta A., Nayini K., Eapen A. et al. Serum inhibin-b may predict successful sperm retrieval in azoospermic men with normal gonadotropin and testosterone levels. Hum Reprod 2012;27(Suppl 2).
13. Ruiz Plazas X., Burgués Gasión J.P., Ozonas Moragues M., Pizá Reus P. Utility of inhibin B in the management of male infertility. Actas Urol Esp 2010;34(9):781–7.
14. Goulis D.G., Polychronou P., Mikos T. et al. Serum inhibin-B and follicle stimulating hormone as predictors of the presence of sperm in testicular fine needle aspirate in men with azoospermia. Hormones 2008;7(2):140–7.
15. Huang X., Bai Q., Yan L.Y. et al. Combination of serum inhibin B and folliclestimulating hormone levels can not improve the diagnostic accuracy on testicular sperm extraction outcomes in Chinese nonobstructive azoospermic men. Chin Med J (Engl) 2012;125(16):2885–9.
16. Moradi M., Alemi M., Moradi A. et al. Does inhibin-B help us to confidently refuse diagnostic testicular biopsy in azoospermia? Iran J Reprod Med 2012;10(3):243–8.
17. Toulis K.A., Iliadou P.K., Venetis C.A. et al. Inhibin B and anti-Mullerian hormone as markers of persistent spermatogenesis in men with non-obstructive azoospermia: a meta-analysis of diagnostic accuracy studies. Hum Reprod Update 2010;16(6):713–24.
Andrology and Genital Surgery. 2015; 16: 8-12
Prognostic significance of ingibin B with infertile patients (review of references)
https://doi.org/10.17650/2070-9781-2015-1-8-12Abstract
Infertility is a polyetiological disease and requires modern universal markers, studying of which could allow determination of the appropriate tactics of treatment of patients with impaired fertility, evaluation of prognosis, and prospects of treatment. Besides, there is an evident trend towards widening of indications to apply auxiliary reproductive technologies in treatment of patients with the most serious factors of male infertility. Inhibin, that is a hormone composed of two subunits, may act as one of such markers that allow judging of the morphological and functional state of the testicular parenchyma. Inhibin B that is produced with Sertoli cells and young spermatogenous cells in the seminiferous tubules is a known endocrine marker for evaluation of spermatogenesis. The review includes analysis of results of the studies that investigated the value of determination of the level of inhibin B in the course of diagnostics of male infertility as well as in the course of prognosis of results of testicular sperm extraction. It has been demonstrated that on the whole inhibin B is a more sensitive marker than the follicle-stimulating hormone. According to a number of authors, due to its high sensitivity and specificity, inhibin B may become the alternative to testicular biopsy, as well as a marker of differential diagnosis of male infertility in future. At the same time, the level of inhibin B in serum may not be used as a singular marker of males with non-obstructive azoospermia. Ambiguous results received require further studies.
References
1. European Association of Urology. Guidelines. 2012; 2014.
2. Bozhedomov V.A., Rokhlikov I.M., Tret'yakov A.A. i dr. Aktual'nye voprosy okazaniya pomoshchi param s muzhskim faktorom bezdetnogo braka: klinicheskie i organizatsionno-metodicheskie aspekty. Andrologiya i genital'naya khirurgiya 2013;(4):7–16. [Bozhedomov V.A., Rokhlikov I.M., Tretyakov A.A. et al. Topical problems of care rendered to childless couples with male factor infertility: clinical, organizational, and methodical aspects. Andrologiya i genital,naya khirurgia = Andrology and Genital Surgery 2013;(4): 7–16. (In Russ.)].
3. Bykov V.L. Spermatogenez u muzhchin v kontse XX veka. Problemy reproduktsii 2000;(1):6–13. [Bykov V.L. Spermatogenesis of males in late XX century. Problemy reproduktsii = Problems of Reproduction 2013;(4):7–16. (In Russ.)].
4. Krause W., Bohring C. Inhibin B as a marker of spermatogenesis. A new dimension in andrology. Hautarzt 2002;53(1):5–10.
5. Dong Z.Y., Yu H., Xiu H.M. et al. Expression of inhibin B subunits in the testicular tissues of azoospermia patients with different pathological alterations. Zhonghua Nan Ke Xue 2008;14(1):20–2.
6. Tyrrell J.B., Findling J.W., Aron D.C. Hypothalamus and pituitary. In: F.S. Greenspan, J.D. Baxter (eds.). Basic and clinical endocrinology. 4th ed. NY: Appleton and Lange, 1994. Pp. 64–127.
7. Anawalt B. D, Bebb R.A., Matsumoto A.M. et al. Serum inhibin B level reflect Sertoli cell function in normal men and men with testicular dysfunction. J Clin Endocrinol Metab 1996;81(9):3341–5.
8. Manzoor S.M., Sattar A., Hashim R. et al. Serum inhibin B as a diagnostic marker of male infertility. J Ayub Med Coll Abbottabad 2012;24(3–4):113–6.
9. Grunewald S., Glander H.J., Paasch U., Kratzsch J. Age-dependent inhibin B concentration in relation to FSH and semen sample qualities: a study in 2448 men. Reproduction 2013;145(3):237–44.
10. Anderson A.M., Muller J., Skakkebaek N.E. Different roles of prepubertal and postpubertal germ cells and Sertoli cells in the regulation of serum inhibin B levels. J Clin Endocrinol Metab 1998;83(12):4451–8.
11. Pierik F.H., Vreeburg J.T. M., Stijnen T. et al. Serum inhibin B as a marker of spermatogenesis. J Clin Endocrinol Metab 1998;83(9):3110–4.
12. Datta A., Nayini K., Eapen A. et al. Serum inhibin-b may predict successful sperm retrieval in azoospermic men with normal gonadotropin and testosterone levels. Hum Reprod 2012;27(Suppl 2).
13. Ruiz Plazas X., Burgués Gasión J.P., Ozonas Moragues M., Pizá Reus P. Utility of inhibin B in the management of male infertility. Actas Urol Esp 2010;34(9):781–7.
14. Goulis D.G., Polychronou P., Mikos T. et al. Serum inhibin-B and follicle stimulating hormone as predictors of the presence of sperm in testicular fine needle aspirate in men with azoospermia. Hormones 2008;7(2):140–7.
15. Huang X., Bai Q., Yan L.Y. et al. Combination of serum inhibin B and folliclestimulating hormone levels can not improve the diagnostic accuracy on testicular sperm extraction outcomes in Chinese nonobstructive azoospermic men. Chin Med J (Engl) 2012;125(16):2885–9.
16. Moradi M., Alemi M., Moradi A. et al. Does inhibin-B help us to confidently refuse diagnostic testicular biopsy in azoospermia? Iran J Reprod Med 2012;10(3):243–8.
17. Toulis K.A., Iliadou P.K., Venetis C.A. et al. Inhibin B and anti-Mullerian hormone as markers of persistent spermatogenesis in men with non-obstructive azoospermia: a meta-analysis of diagnostic accuracy studies. Hum Reprod Update 2010;16(6):713–24.
