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L’Inhibine B sérique, marqueur sensible de la production spermatique chez l’homme

Serum inhibin B level is a sensitive marker of human sperm production

Résumé

Des données acquises au cours des dernières années indiquent que le dosage de l’inhibine B sérique est un marqueur très utile de la spermatogenèse. Le propos du présent travail était l’évaluation de cette technique à l’occasion de son transfert technologique dans notre hôpital par l’étude d’hommes dans différentes situations cliniques consultant pour infécondité du couple. Nous avons ainsi pu confirmer l’intérêt majeur du dosage de l’inhibine B par le “dimeric assay” à côté du dosage de la FSH pour évaluer de manière indirecte la spermatogenèse de ces hommes. Nous avons trouvé que les valeurs d’inhibine B sérique étaient en corrélation directe avec le niveau de production spermatique et en corrélation inverse avec le taux de FSH. Cependant les taux d’inhibine B présentaient un meilleur pouvoir discriminant que les taux de FSH. Par exemple, la mesure de l’inhibine B différenciait les hommes présentant une oligozoospermie sévère des hommes azoosperme de manière beaucoup plus significative que la FSH (p=0,0002 vs p=0,007 respectivement). D’une manière générale, les résultats obtenus dans la présente étude étaient similaires à ceux rapportés dans les études déjà publiées reposant sur la même technique de dosage. En résumé et sur le plan pratique, le dosage de l’inhibine B est sensible et beaucoup plus spécifique que celui de la FSH pour refléter le niveau de fonctionnalité de la spermatogenèse et dans les cas des azoospermies, le dosage de l’inhibine B semble particulièrement intéressant pour distinguer azoospermies sécrétoires et excrétoires.

Abstract

Several recent papers indicate that the blood concentration of inhibin B measured by the dimeric assay is a marker of human spermatogenesis. The aim of the present study was to validate the dimeric assay in our hospital. For this purpose, we studied a population of 106 patients attending our infertility clinic. We found that serum inhibin B levels were positively correlated with the level of sperm production as reflected by the sperm concentration and negatively correlated with serum FSH levels. Serum inhibin B concentrations were found to be superior to FSH levels for discriminating between subgroups of patients with different levels of sperm production. For example, the differences in the inhibin B levels in severe oligozoospermia (< 5×106 sperm/ml) compared to non-obstructive azoospermia were more pronounced than the differences in FSH (p=0.0002 vs p=0.007, respectively). Overall, the results obtained in the present study were similar to those reported in other studies based on the same assay. Serum inhibin B levels in patients with non obstructive azoospermia were ten times lower than in patients with normal sperm concentrations. From a practical point of view, the measurement of serum inhibin B opens up new possibilities for the diagnosis and prognosis of many testicular disorders. Firstly, serum inhibin B determination should be performed whenever reproductive hormones are prescribed. In the particular case of azoospermia, serum inhibin B concentrations appear to be particularly useful to distinguish between obstructive and non-obstructive situations. Finally, according to a recent publication, a serum inhibin B cut-off value (> 40 pg/mL) could predict the success of testicular sperm extraction in patients with non-obstructive azoospermia. Serum inhibin B could therefore represent a unique non-invasive marker of focal hypospermatogenesis in men with non-obstructive azoospermia, who are candidates for intracytoplasmic sperm injection (ICSI) and a useful early marker to monitor possible recovery of spermatogenesis after chemotherapy or radiotherapy.

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Correspondence to J. Auger.

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Fulla, Y., Auger, J., Allali, S. et al. L’Inhibine B sérique, marqueur sensible de la production spermatique chez l’homme. Androl. 11, 21–35 (2001). https://doi.org/10.1007/BF03034507

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Mots-clés

  • Inhibine B
  • FSH
  • testicule
  • spermatogenèse
  • concentration de spermatozoïdes
  • infertilité masculine

Key words

  • Inhibin B
  • FSH
  • testis
  • spermatogenesis
  • sperm concentration
  • male infertility
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