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

PURPOSE:

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.

PATIENTS AND 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%.

CONCLUSION:

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: Daniel M Green, Liang Zhu, Nan Zhang, Charles A Sklar, Raymond W Ke, William H Kutteh, James L Klosky, Sheri L Spunt, Monika L Metzger, Fariba Navid, DeoKumar Srivastava, Leslie L Robison, Melissa M Hudson
• Journal: Journal of clinical oncology : official journal of the American Society of Clinical Oncology (J Clin Oncol) Vol. 31 Issue 10 Pg. 1324-8 (Apr 01 2013) ISSN: 1527-7755 [Electronic] United States
• PMID: 23423746 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)

Chemical References

• Follicle Stimulating Hormone, beta Subunit
• Glycoprotein Hormones, alpha Subunit
• inhibin B
• Inhibins
• Follicle Stimulating Hormone

Topics

• Adolescent
• Adult
• Azoospermia (blood, diagnosis)
• Child
• Child, Preschool
• Cohort Studies
• Follicle Stimulating Hormone (blood)
• Follicle Stimulating Hormone, beta Subunit (blood)
• Glycoprotein Hormones, alpha Subunit (blood)
• Humans
• Infant
• Infant, Newborn
• Inhibins (blood)
• Male
• Middle Aged
• Neoplasms (blood, diagnosis, therapy)
• Predictive Value of Tests
• ROC Curve
• Semen (cytology)
• Sperm Count
• Survivors
• Young Adult