Increased serum inhibin B levels after varicocele treatment.
OBJECTIVE
Inhibin B is secreted by Sertoli cells in response to FSH and is the major feedback regulator of FSH secretion in man. The serum inhibin B level has emerged as a good marker of spermatogenesis and Sertoli cell function. Varicocele has been associated with infertility and disturbed spermatogenesis. We have studied the effect of varicocele treatment on serum inhibin B levels, with the aim of investigating the effect on spermatogenesis and the involvement of the Sertoli cell in varicocele pathophysiology.


METHODS
In a pre-post test design, the effect of varicocele surgery on inhibin B levels was studied in 30 infertile men.


METHODS
Endocrinology (inhibin B, FSH, LH, SHBG and testosterone) and semen analysis (sperm concentration, motility and morphology).


RESULTS
In men receiving varicocele treatment, a significant increase in serum inhibin B levels was observed from 133.9 +/- 13.4 pretreatment to 167.8 +/- 16.1 ng/l after treatment (mean +/- SEM, P < 0.0001). No significant changes were observed in serum levels of FSH, LH and testosterone. The serum SHBG level decreased from 32.9 +/- 3.5 to 28.6 +/- 3.4 nmol/l (mean +/- SEM, P = 0.04) and the free androgen index was significantly increased from 66 +/- 5.9 pretreatment to 85 +/- 6.8 after treatment (P = 0.02, mean +/- SEM). Semen analysis showed a significant improvement in sperm concentration, from 6.5 +/- 1.9 pretreatment to 19.3 +/- 4.9 x 106/ml after treatment (P = 0.003, mean +/- SEM), and in sperm motility from the baseline level of 17 +/- 3 to 32 +/- 4% after treatment (P = 0.001, mean +/- SEM).


CONCLUSIONS
Varicocele treatment can increase serum inhibin B levels, indicating improvement of spermatogenesis and Sertoli cell function. This finding suggests that the pathophysiology of varicocele involves impairment of Sertoli cell function or a different distribution of germ cell stages.
Pierik
F H
FH
Department of Andrology, Internal Medicine and Public Health, Erasmus Medical Centre Rotterdam, The Netherlands. pierik@mgz.fgg.eur.nl
Abdesselam
S A
SA
Vreeburg
J T
JT
Dohle
G R
GR
De Jong
F H
FH
Weber
R F
RF
D000328:Adult; D015415:Biomarkers / Q000097:blood; D005640:Follicle Stimulating Hormone / Q000097:blood; D006801:Humans; D007265:Inhibins / Q000097:blood*; D007986:Luteinizing Hormone / Q000097:blood; D008297:Male; D029584:Prostatic Secretory Proteins; D020033:Protein Isoforms / Q000097:blood; D012708:Sertoli Cells; D013076:Sperm Count; D013081:Sperm Motility; D013091:Spermatogenesis; D018709:Statistics, Nonparametric; D013739:Testosterone / Q000097:blood; D014646:Varicocele / Q000097:blood* / Q000473:pathology / Q000601:surgery
D015415:Biomarkers; D029584:Prostatic Secretory Proteins; D020033:Protein Isoforms; C043076:beta-microseminoprotein; D013739:Testosterone; D007265:Inhibins; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone