In adult male, serum level of inhibin B is stable throughout life [ 38 ]. Inhibin B expression and secretion in men is positively correlated with Sertoli cell function and number, sperm number and spermatogenic status and negatively correlated with FSH [ 39 ]. Men with hypospermatogenesis and spermatogenesis arrest may have lower levels of inhibin B. Men with sertoli cell only SCO syndrome have extremely low levels of inhibin B [ 34 , 37 ]. Suppression of spermatogenesis by exogenous testosterone or chemotherapy decreases serum inhibin B.
It is a good marker of spermatogenesis and may offer an improved diagnosis of testicular dysfunction [ 34 , 40 ]. Based on these observations, it has been suggested that inhibin B could be a good marker for spermatogenesis [ 41 ].
Anti-mullerian hormone AMH is a glycoprotein. It is involved in the regulation of tissue growth and differentiation. AMH is produced by the sertoli cells of testis in the male, and by ovarian granulosa cells in the female. During embryonic development in male, secretion of AMH from testicular Sertoli cells is essential for the regression of the Mullerian ducts, and thus the normal development of the male reproductive tract.
In the male, secretion of AMH by the Sertoli cells commences during embryogenesis and continues throughout life. AMH blood concentration decreases dramatically during puberty [ 42 ] and persists at very low values in adults [ 43 ]. Very little is known about the function of AMH in postnatal life; it has recently been shown that it controls Leydig cell proliferation and steroidogenic function [ 44 ] and that it may be related to germinal cell proliferation [ 45 ]. AMH is expected to be high in cases of sertoli cell immaturity as well as with conditions like sertoli cell hyperplasia or tumor.
Maymon et al. Low AMH reflects a primary alteration in Sertoli cell function or number that may leads to spermatogenic arrest. Lactate is produced by sertoli cells and used by germ cells as an energy substrate [ 48 ]. Sertoli cells have enormous capacity of converting glucose into lactate. Round spermatids and pachytene spermatocytes are dependent on lactate [ 49 ], whereas ejaculated spermatozoa can use glucose or fructose as substrates [ 50 ].
Lactate could therefore be an important intermediate for the regulation of the survival of pachytene spermatocytes and round spermatids. One should expect low value of lactate in late maturation arrest post meiotic; round stage. A high value of lactate indicates either nonutilization of lactate by germ cells as with SCOS or sertoli cell dysfunction. Seminal lactate as a marker of PTF seems complex and no co-relation was detectable.
Seminal lactate does not provide any important inputs. Furthermore, we did not find any differences in AMH, Inhibin B and seminal lactate with or without chromosome abnormality or Yq microdeletion. The classic predictors of spermatogenesis are testicular size, semen analysis, FSH level and testicular histology. However, in our experience we have found frequently contradicting findings viz.
The FSH value is often normal in these subgroups. It is also observed in hypospermatogenesis [ 35 ]. Inhibin B seems a better predictor in these situations. It can discriminate between complete absence of germ cells and less severe disturbances of sperm production in the testis. This is also supported by observation of more accurate prediction of the presence of testicular spermatozoa in nonobstructive azoospermia with the level of serum inhibin B [ 51 , 52 ]. Different views exist in the literature between FSH and inhibin B with spermatogenesis.
In infertile patients with primary gonadal failure, inhibin B decreases and FSH increases. In general, there is good correlation with the degree of spermatogenic damage; arrest at the earlier stages having the lowest inhibin B levels viz. Sertoli cell only syndrome. Philadelphia, PA: Elsevier Saunders; chap Fundamental concepts regarding testosterone deficiency and treatment: international expert consensus resolutions.
Mayo Clin Proc. PMID: www. US Food and Drug Administration website. FDA drug safety communication: FDA cautions about using testosterone products for low testosterone due to aging; requires labeling change to inform of possible increased risk of heart attack and stroke with use. Updated February 26, Accessed May 20, Editorial team. Testicular failure. Testicular failure is uncommon. Editorial team. Doctors St. E-mail Form. Testicular failure Primary hypogonadism - male.
Testicles The testes are 2 egg-shaped male reproductive organs located in the scrotum. Hemochromatosis Hemochromatosis is a condition in which there is too much iron in the body. Mumps Mumps is a contagious disease that leads to painful swelling of the salivary glands.
Orchitis Orchitis is swelling inflammation of one or both of the testicles. Testicular cancer Testicular cancer is cancer that starts in the testicles. Testicular torsion Testicular torsion is the twisting of the spermatic cord, which supports the testes in the scrotum.
Varicocele A varicocele is the swelling of the veins inside the scrotum. Cystic fibrosis Cystic fibrosis is a disease that causes thick, sticky mucus to build up in the lungs, digestive tract, and other areas of the body.
Scrotum The scrotum is a part of a male's body that is located behind the penis. Marijuana Substance use is the continued use of alcohol, illegal drugs, or the misuse of prescription or over-the-counter drugs with negative consequences. Undescended testicles Undescended testicle occurs when one or both testicles fail to move into the scrotum before birth. Enlarged breasts When abnormally large breasts develop in males, it is called gynecomastia.
Testosterone A testosterone test measures the amount of the male hormone, testosterone, in the blood. Open References. All Video Images Tog. Endocrine glands - illustration Endocrine glands release hormones chemical messengers into the bloodstream to be transported to various organs and tissues throughout the body.
Endocrine glands illustration. Male reproductive anatomy - illustration The male reproductive structures include the penis, the scrotum, the seminal vesicles and the prostate. Elsevier; Accessed Aug. Snyder PJ. Clinical features and diagnosis of male hypogonadism.
Male hypogonadism adult. Mayo Clinic; Testosterone treatment of male hypogonadism. Delayed male puberty child. Sargis RM, et al. Evaluation and treatment of male hypogonadism. Journal of the American Medical Association. Gardner DG, et al. In: Greenspan's Basic and Clinical Endocrinology. McGraw-Hill Education; Male hypogonadism. Merck Manual Professional Version. FDA approves new oral testosterone capsule for treatment of men with certain forms of hypogonadism. Accessed Sept. Bhasin S, et al.
Testosterone therapy in men with hypogonadism: An Endocrine Society clinical practice guideline. The Journal of Clinical Endocrinology and Metabolism.
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