Inhibin B: are modified ranges needed for orchiectomised testicular cancer patients?
Alessandra Petrozzi1, Francesco Pallotti1, Marianna Pelloni1, Antonella Anzuini2, Antonio Francesco Radicioni2, Andrea Lenzi1, Donatella Paoli1, Francesco Lombardo1
1 Laboratory of Seminology, Sperm Bank "Loredana Gandini", Department of Experimental Medicine, Medical Pathophysiology Section, "Sapienza" University of Rome, Rome 00161, Italy
2 Hormone Laboratory, Department of Experimental Medicine, Medical Pathophysiology Section, "Sapienza" University of Rome, Rome 00161, Italy
Laboratory of Seminology, Sperm Bank “Loredana Gandini”, Department of Experimental Medicine, Medical Pathophysiology Section, “Sapienza” University of Rome, Rome 00161, Italy
Source of Support: None, Conflict of Interest: None
Inhibin B is a gonadal hormone that downregulates the pituitary production of follicle-stimulating hormone (FSH). In recent years, inhibin B has proved to be an excellent marker of spermatogenesis and even a predictive factor for the recovery of fertility in patients undergoing orchiectomy and antineoplastic treatments. We propose to study inhibin B levels in orchiectomised testicular cancer patients, in order to identify a minimum value representative of normal semen quality. This retrospective study evaluates hormonal and semen parameters of 290 normozoospermic patients attending the Laboratory of Seminology - Sperm Bank “Loredana Gandini” (Rome, Italy) for cryopreservation of seminal fluid following a diagnosis of testicular cancer (TC group) and 117 healthy, normozoospermic men as a control group (CTR group). The percentile distribution of gonadotropin and inhibin B values in the TC and CTR groups was analyzed. There was a statistically significant difference between the two groups in the levels of all hormones (P ≤ 0.001) and in all semen parameters (P < 0.05). About 20% of TC patients revealed inhibin B levels below the 5th percentile of CTR group, despite normozoospermia, and 31.4% had normal spermatogenesis in the presence of FSH values >95th percentile of CTR group. Orchiectomised patients for testicular cancer presented inhibin B levels lower than healthy patients, despite normozoospermia. Our study revealed the poor sensitivity of the current inhibin B reference range when applied to monorchidic patients, suggesting the need to establish more representative ranges to enable more appropriate counseling in relation to the patient's new endocrine condition.