title: Lack of specificity of plasma concentrations of inhibin B and follicle-stimulating hormone for identification of azoospermic survivors of childhood cancer: a report from the St Jude lifetime cohort study.
abstract: OBJECTIVE
  Many male survivors of childhood cancer are at risk for azoospermia. Although both the levels of follicle-stimulating hormone (FSH) and inhibin B are correlated with sperm concentration, their ability to predict azoospermia in survivors of childhood cancer remains uncertain.
  
  
  METHODS
  Semen analysis was performed and serum levels of FSH and inhibin B were measured in 275 adult male survivors of childhood cancer who had received gonadotoxic therapy. Receiver operating characteristic (ROC) analysis was performed to determine the optimal inhibin B and FSH values for identifying patients with azoospermia. The patient sample was divided into a learning set and a validation set. Sensitivity, specificity, and positive and negative predictive value were calculated.
  
  
  RESULTS
  Inhibin B was dichotomized as ≤ 31 ng/L or more than 31 ng/L and FSH was dichotomized as ≤ 11.5 mIU/mL or more than 11.5 mIU/mL based on results of the ROC analysis. Using these values, the specificity of the serum level of inhibin B for identifying azoospermic survivors was 45.0%, and the positive predictive value was 52.1%. The specificity for FSH was 74.1%, and the positive predictive value was 65.1%.
  
  
  CONCLUSIONS
  Neither serum inhibin B nor FSH is a suitable surrogate for determination of sperm concentration in a semen sample. Young men and their physicians should be aware of the limitations of these measures for assessment of fertility potential.
authors: Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN 38105-2794, USA. daniel.green@stjude.org
authors: Daniel M
authors: DM
authors: Green
authors: Liang
authors: L
authors: Zhu
authors: Nan
authors: N
authors: Zhang
authors: Charles A
authors: CA
authors: Sklar
authors: Raymond W
authors: RW
authors: Ke
authors: William H
authors: WH
authors: Kutteh
authors: James L
authors: JL
authors: Klosky
authors: Sheri L
authors: SL
authors: Spunt
authors: Monika L
authors: ML
authors: Metzger
authors: Fariba
authors: F
authors: Navid
authors: DeoKumar
authors: D
authors: Srivastava
authors: Leslie L
authors: LL
authors: Robison
authors: Melissa M
authors: MM
authors: Hudson
mesh_terms: D000293:Adolescent; D000328:Adult; D053713:Azoospermia / Q000097:blood* / Q000175:diagnosis; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005640:Follicle Stimulating Hormone / Q000097:blood*; D037201:Follicle Stimulating Hormone, beta Subunit / Q000097:blood; D015292:Glycoprotein Hormones, alpha Subunit / Q000097:blood; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007265:Inhibins / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000097:blood* / Q000175:diagnosis / Q000628:therapy; D011237:Predictive Value of Tests; D012372:ROC Curve; D012661:Semen / Q000166:cytology; D013076:Sperm Count; D017741:Survivors; D055815:Young Adult
chemical_list: D037201:Follicle Stimulating Hormone, beta Subunit; D015292:Glycoprotein Hormones, alpha Subunit; C422364:inhibin B; D007265:Inhibins; D005640:Follicle Stimulating Hormone