Increased serum inhibin B levels after varicocele treatment

• Published in: Clinical endocrinology (Oxford) Vol. 54; no. 6; pp. 775 - 780
• Main Authors: Pierik, Frank H., Abdesselam, Salem Aït, Vreeburg, Jan T. M., Dohle, G. R., De Jong, Frank H., Weber, Robertus F. A.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Science Ltd 01-06-2001; Blackwell; Wiley Subscription Services, Inc
• Subjects: Adult; Biological and medical sciences; Biomarkers - blood; Follicle Stimulating Hormone - blood; Gynecology. Andrology. Obstetrics; Humans; Inhibins - blood; Luteinizing Hormone - blood; Male; Male genital diseases; Medical sciences; Non tumoral diseases; Prostatic Secretory Proteins; Protein Isoforms - blood; Sertoli Cells; Sperm Count; Sperm Motility; Spermatogenesis; Statistics, Nonparametric; Testosterone - blood; Varicocele - blood; Varicocele - pathology; Varicocele - surgery; Human; Sertoli cell; Varicocele; Cell function; Spermatogenesis; Inhibin; Male; Concentration; Testosterone; Clinical biology; Complication; Male genital diseases; Testicular diseases
• ISSN: 0300-0664; 1365-2265
• DOI: 10.1046/j.1365-2265.2001.01302.x

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.
DESIGN AND PATIENTS In a pre–post test design, the effect of varicocele surgery on inhibin B levels was studied in 30 infertile men.
MEASUREMENTS 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 × 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.