Hamza Benderradji1, Julie Prasivoravong2, François Marcelli2, Anne-Laure Barbotin3, Sophie Catteau-Jonard4, Carole Marchetti5, Catherine Guittard6, Philippe Puech7, Valérie Mitchell3, Jean-Marc Rigot2, Arnauld Villers2, Pascal Pigny8, Clara Leroy2. 1. Department of Andrology, Urology and Renal Transplantation, Claude Huriez Hospital, Lille University Hospital, 1 Place de Verdun, 59045, Lille Cedex, France. hamza.benderradji@inserm.fr. 2. Department of Andrology, Urology and Renal Transplantation, Claude Huriez Hospital, Lille University Hospital, 1 Place de Verdun, 59045, Lille Cedex, France. 3. Department of Reproductive Biology-Spermiology-CECOS, Lille University Hospital, Lille, France. 4. Department of Endocrine Gynecology and Reproductive Medicine, Lille University Hospital, Lille, France. 5. Department of Reproductive Biology, BIOLILLE Laboratory, Lille, France. 6. Department of Reproductive Medicine, Bois Blanc Hospital, Lille, France. 7. Department of Radiology, Lille University Hospital, Lille, France. 8. Department of Biochemistry & Hormonology, Lille University Hospital, Lille, France.
Abstract
BACKGROUND: Testicular sperm extraction (TESE) is the method of choice for recovering spermatozoa in patients with azoospermia. However, the lack of reliable biomarkers makes it impossible to predict sperm retrieval outcomes at TESE. To date, little attention has been given to anti-Müllerian hormone (AMH) serum levels in adult men with altered spermatogenesis. In this study we aimed to investigate whether serum concentrations of AMH and the AMH to total testosterone ratio (AMH/T) might be predictive factors for sperm retrieval outcomes during TESE in a cohort of 155 adult Caucasian men with azoospermia. RESULTS: AMH serum levels were significantly lower in nonobstructive azoospermia (NOA) that was unexplained, cryptorchidism-related, cytotoxic and genetic (medians [pmol/l] = 30.1; 21.8; 26.7; 7.3; and p = 0.02; 0.001; 0.04; <0.0001, respectively]) compared with obstructive azoospermia (OA) (median = 44.8 pmol/l). Lowest values were observed in cases of genetic NOA (p < 0.0001, compared with unexplained NOA) and especially in individuals with non-mosaic Klinefelter syndrome (median = 2.3 pmol/l, p <0.0001). Medians of AMH/T values were significantly lower in genetic NOA compared to unexplained, cryptorchidism-related NOA as well as OA. Only serum concentrations of AMH differed significantly between positive and negative groups in men with non-mosaic Klinefelter syndrome. The optimal cut-off of serum AMH was set at 2.5 pmol/l. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of this cut-off to predict negative outcomes of SR were 100 %, 76.9 %, 66.6 %, 100 and 84.2 %, respectively. CONCLUSIONS: Serum AMH levels, but not AMH/T values, are a good marker for Sertoli and germ cell population dysfunction in adult Caucasian men with non-mosaic Klinefelter syndrome and could help us to predict negative outcomes of SR at TESE with 100 % sensitivity when serum levels of AMH are below 2.5 pmol/l.
BACKGROUND: Testicular sperm extraction (TESE) is the method of choice for recovering spermatozoa in patients with azoospermia. However, the lack of reliable biomarkers makes it impossible to predict sperm retrieval outcomes at TESE. To date, little attention has been given to anti-Müllerian hormone (AMH) serum levels in adult men with altered spermatogenesis. In this study we aimed to investigate whether serum concentrations of AMH and the AMH to total testosterone ratio (AMH/T) might be predictive factors for sperm retrieval outcomes during TESE in a cohort of 155 adult Caucasian men with azoospermia. RESULTS:AMH serum levels were significantly lower in nonobstructive azoospermia (NOA) that was unexplained, cryptorchidism-related, cytotoxic and genetic (medians [pmol/l] = 30.1; 21.8; 26.7; 7.3; and p = 0.02; 0.001; 0.04; <0.0001, respectively]) compared with obstructive azoospermia (OA) (median = 44.8 pmol/l). Lowest values were observed in cases of genetic NOA (p < 0.0001, compared with unexplained NOA) and especially in individuals with non-mosaic Klinefelter syndrome (median = 2.3 pmol/l, p <0.0001). Medians of AMH/T values were significantly lower in genetic NOA compared to unexplained, cryptorchidism-related NOA as well as OA. Only serum concentrations of AMH differed significantly between positive and negative groups in men with non-mosaic Klinefelter syndrome. The optimal cut-off of serum AMH was set at 2.5 pmol/l. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of this cut-off to predict negative outcomes of SR were 100 %, 76.9 %, 66.6 %, 100 and 84.2 %, respectively. CONCLUSIONS: Serum AMH levels, but not AMH/T values, are a good marker for Sertoli and germ cell population dysfunction in adult Caucasian men with non-mosaic Klinefelter syndrome and could help us to predict negative outcomes of SR at TESE with 100 % sensitivity when serum levels of AMH are below 2.5 pmol/l.
Authors: R A Rey; C Belville; C Nihoul-Fékété; L Michel-Calemard; M G Forest; N Lahlou; F Jaubert; I Mowszowicz; M David; N Saka; C Bouvattier; A M Bertrand; C Lecointre; S Soskin; S Cabrol; H Crosnier; J Léger; S Lortat-Jacob; M Nicolino; W Rabl; S P Toledo; F Baş; A Gompel; P Czernichow; N Josso Journal: J Clin Endocrinol Metab Date: 1999-02 Impact factor: 5.958