EVALUATION OF INHIBIN B AND FSH IN SERUM AND SEMINAL PLASMA IN DIFFERENT GROUPS OF INFERTILE MEN.

Background: Treatment of infertility-related hormonal dysfunction in men requires an understanding of the hormonal basis of spermatogenesis. The best method for accurately determining male androgenization status remains elusive. Objective: This study is designed to evaluation the levels of serum and seminal plasma Inhibin B and FSH in relevance to sperm function parameters in different groups of infertile patients. Subject, Material and Methods: This study was carried out in the High Institute of Infertility Diagnosis and Assisted Reproductive Technologies \\ AL- Nahrain University, Baghdad-Iraq ; during the period of from September 2016 to July 2017. Forty five man were enrolled in this study, thirty of them were within infertility groups, and Fifteen were Normozoospermia as control. The infertile group subdivided into 11 male with oligozoospermia and 4 cryptozoospermia and 15 were patient with Azoospermia (9 obstructive and 6 non obstructive azoospermia). Comparison in the levels of serum and seminal plasma Inhibin B and FSH in relevance to sperm function parameters in different groups were done. Results: There was highly significant difference between control group and study group in all seminal fluid parameters. The highest value of serum FSH was in NOA group and lowest value was in OA and normozoospermia and have highly significant value(P= 0.0001). Serum Inhibin B shown highly significant value (P=0.00947) in comparison between groups and highest value seen in NOA and other groups have nearly convergent values. Both FSH and Inhibin B in seminal plasma have non-significant value when compared between control group and study sub groups. Highly significant difference of FSH in serum and seminal plasma between fertile(control) group and infertile subgroups observed in each of oligozoospermia, cryptozoospermia and NOA and significant difference observed in normozoospermia and OA. Comparison of Inhibin B in serum and seminal plasma between fertile (control) group and infertile sub groups showed highly significant difference in each of cryptozoospermia , OA and NOA and significant difference in normozoospermia and non-significant difference seen in oligozoospermia. Comparison of hormones in serum between fertile group and infertile subgroup showed significant value in Inhibin B but not in FSH. Highly significant positive correlation seen between age and level of FSH in serum, and significant positive correlation between age and FSH level in seminal plasma. Highly significant negative correlation between serum FSH and both of progressive motile sperm and normal morphology ,and significant with negative correlation with sperm concentration ,while significant positive correlation between FSH and non-progressive and immotile sperm. FSH in seminal plasma shown significant negative correlation with progressive motility, significant positive correlation with immotile sperm, and highly significant negative correlation with normal morphology. The most sensitive test was Inhibin B in serum while the most specific test was FSH in seminal plasma in relation to abnormal sperms parameters. Conclusion: 1-High level of serum FSH and seminal plasma Inhibin B enhance to precise laboratory diagnosis for cryptozoospermia patient , particularly for those nominate for IVF or ICSI . 2-The best test used for detection of NOA is evaluation of Inhibin B in serum .3-FSH increased with aging .4-FSH have inverse relationship with progressive motile sperm as well as normal morphology of sperms.5-Serum Inhibin B -FSH index is more sensitive than serum FSH alone , but sensitivity of seminal Inhibin B - FSH index is about double of seminal plasma FSH alone .6- FSH test alone more specific test than Inhibin B-FSH index in both serum and seminal plasma.