Effects of low concentrations of inhibin B on the outcomes of testicular sperm extraction and intracytoplasmic sperm injection

Objective: To study the effects of undetectable inhibin B concentrations on the outcomes of testicular sperm extraction (TESE) and of intracytoplasmic sperm injection (ICSI). Design: Retrospective study. Setting: Obstetrics, gynecology, and reproductive biology departments. Patient(s): We carried out TESE on 75 men with nonobstructive azoospermia: 42 men had an inhibin B concentration of <15 pg/mL (group 1), and 33 had an inhibin B concentration of greater than or equal to 15 pg/mL (group 2). Twenty-five ICSI cycles were carried out using sperm from men in group 1 (group A1), and 35 ISCI cycles were carried out using sperm from men in group 2 (group A2). The outcomes of ICSI in groups A1 and A2 were compared with those of 81 ICSI cycles performed for obstructive azoospermia (group B). Intervention(s): Testicular sperm extraction, testicular spermatozoa cryopreservation, and ICSI. Main Outcome Measure(s): Testicular sperm extraction outcome, pregnancy, and delivery. Result(s): Sperm were significantly less likely to be successfully recovered from men in group 1 than from those in group 2 (21% vs. 48%). The inhibin B concentration was significantly lower in men in whom TESE failed, but the FSH concentration did not differ. The implantation rate per embryo transferred was twofold lower in group A1 (7.4%) than in group B (16%), but this difference is not statistically significant. Conclusion(s): Patients with undetectable inhibin B concentration should be informed of the low chances of positive testicular biopsy, and more embryos should be transferred to improve the success rate. (C) 2003 by American Society for Reproductive Medicine.