Nery S F, Vieira M A F, Dela Cruz C, Lobach V N M, Del Puerto H L, Torres P B, Rocha A L L, Reis A B, Reis F M
Division of Human Reproduction and Andrology, Department of Obstetrics & Gynecology, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
Andrology. 2014 Nov;2(6):918-23. doi: 10.1111/andr.278. Epub 2014 Oct 1.
The rate of motile sperm recovery after cryopreservation is very variable and difficult to predict. Anti-Müllerian hormone (AMH) and inhibin B are produced by Sertoli cells and released into the seminal plasma, where they could be functional markers of spermatogenesis and sperm resistance to thermal stress. The aim of this study was to evaluate whether seminal plasma levels of AMH and inhibin B predict sperm recovery after cryopreservation. The study included 153 men enrolled prospectively during a semen analysis. The cohort was stratified by the fresh semen characteristics into: normal (n = 52), high sperm count (n = 55), asthenozoospermia (n = 23), and oligozoospermia (n = 23). The main outcome measure was motile sperm recovery rate, defined as post-thaw total motile sperm count × 100/pre-freezing total motile sperm count. In men with asthenozoospermia there was a significant correlation between motile sperm recovery rate and the pre-freezing concentrations of AMH (r = 0.522, p < 0.05) and inhibin B (0.471, p < 0.05). In this group, the areas under the receiver operating characteristic curves of AMH and inhibin B for prediction of ≥50% motile sperm recovery after cryopreservation were, respectively, 0.808 and 0.638. AMH was particularly useful, with sensitivity of 0.85, specificity of 0.80, positive predictive value of 0.84 and negative predictive value of 0.80. The sensitivity, specificity, positive, and negative predictive values of inhibin B for the same outcome were, respectively, 0.62, 0.60, 0.67, and 0.55. The median motile sperm recovery rate was 83% when seminal plasma AMH concentration was ≥0.84 ng/mL, vs. 27% when AMH concentration was <0.84 ng/mL (p < 0.05). In other patient groups, there was no correlation between the two hormone levels in seminal plasma and the motile sperm recovery rate. In conclusion, seminal plasma AMH and inhibin B concentrations correlate with and can be used to predict motile sperm recovery after semen cryopreservation in asthenozoospermic men.
冷冻保存后活动精子的回收率差异很大且难以预测。抗苗勒管激素(AMH)和抑制素B由支持细胞产生并释放到精浆中,它们可能是精子发生和精子对热应激抵抗力的功能标志物。本研究的目的是评估精浆中AMH和抑制素B的水平是否能预测冷冻保存后的精子回收率。该研究纳入了153名在精液分析期间前瞻性招募的男性。根据新鲜精液特征将队列分为:正常(n = 52)、高精子计数(n = 55)、弱精子症(n = 23)和少精子症(n = 23)。主要观察指标是活动精子回收率,定义为解冻后活动精子总数×100/冷冻前活动精子总数。在弱精子症男性中,活动精子回收率与冷冻前AMH浓度(r = 0.522,p < 0.05)和抑制素B浓度(0.471,p < 0.05)之间存在显著相关性。在该组中,AMH和抑制素B预测冷冻保存后活动精子回收率≥50%的受试者工作特征曲线下面积分别为0.808和0.638。AMH特别有用,敏感性为0.85,特异性为0.80,阳性预测值为0.84,阴性预测值为0.80。抑制素B对相同结果的敏感性、特异性、阳性和阴性预测值分别为0.62、0.60、0.67和0.55。当精浆AMH浓度≥0.84 ng/mL时,活动精子回收率中位数为83%,而当AMH浓度<0.84 ng/mL时为27%(p < 0.05)。在其他患者组中,精浆中两种激素水平与活动精子回收率之间无相关性。总之,精浆AMH和抑制素B浓度与弱精子症男性精液冷冻保存后的活动精子回收率相关,可用于预测该回收率。