Value of Serum Inhibin B as a Prognostic Factor in Patients with Non-obstructive Azoospermia

Background: Non-obstructive Azoospermia (NOA) mean absence of sperm in the ejaculate due to testicular failure. The sole treatment till now for them is testicular sperm retrieval and ICSI. There is no single test can predict precisely the presence of sperm in testicular the testis. Several studies around the world hypothesized that testicular hormone especially inhibin B can make decision about the sperm retrieval. The objective of this study was to evaluate the efficacy of serum inhibin B level in non-obstructive azoospermia as predictor for sperm retrieval by using testicular sperm extraction (TESE). Methods: This cross-sectional study carried out on 188 men with non-obstructive azoospermia. A detailed medical history, physical examination, age, duration of infertility and BMI was recorded. Men with obstructive azoospermia are excluded from the study. About 5 ml of venous blood taken from them to measure serum inhibin B, FSH, LH, Prolactin and Testosterone before doing testicular sperm retrieval.Results: From the studied sample, (45.7%) were positive testicular sperm retrieval, while (54.3%) were negative sperm retrieval. the median level of INHB for the positive TESE was (54.7pg/ml) which is significantly higher than that for TESE negative (24pg/ml). With representation of INHB values on ROC curve, the sensitivity was 70.9% and specificity was 50% with cutoff 24 pg/ml. Conclusion: Inhibin B is significantly higher in TESE positive patients but with not far enough sensitivity and specificity to predict the presence of sperm.Keywords: Inhibin B; Non-obstructive azoospermia; Infertility; Testicular sperm extraction (TESE)