Significant value of hormonal assays as a marker for Male Infertility in Tikrit city.

Abstract

Background: Infertility is defined as the failure of a couple to conceive after one year of regular unprotected intercourse. Infertility is a problem of global proportions. Several studies with questionable results have focused on the value of serum FSH and AMH to predict the status of spermatogenesis in the testes. Also, possible relationship between seminal plasma inhibin B and spermatogenesis in patients with azoospermia. Aim: The aim of the present study is to compare some serum biomarkers of infertile men with normal fertile men to find the significant value of hormonal assay marker in predication of male infertility.Patients & Methods: A cross sectional study in which samples were obtained from urology clinic in Tikrit teaching hospital, private clinic, from 1-9- 2011 to 1-9-2012. Ninety subjects were participated in the present study (Fifty infertile men & forty fertile subjects). Semen parameters were measured for infertile men & control fertile men. Serum concentrations of FSH, LH, testosterone, AMH & prolactin were measured. Results: There is significant (p< 0.01) reduction in sperm count, motility, viability of infertile men, as compared with same parameters of normal fertile men. Also, there is significant increase in serum MDA (6.811± 0.53 µmol/l) in infertile men as compared with fertile men, (2.454 ± 0.54**). However, there is significant reduction in serum glutathione (p<0.01) in infertile patients (7.1 ± 1.2 µmol/l) as compared with fertile men, (10.123 ± 1.21**). Serum FSH, LH, and testosterone levels were found significantly differences between infertile men (11.35 ± 2.4 mIU/ml, 9.956 ± 2.87 mIU/ml & 5.07 ± 0.62 ng/ml respectively) as compared with serum FSH, LH, and testosterone levels of fertile men (5.53 ± 2.3*, 5.973 ± 0.92** and 9.16 ± 0.749**) respectively. The present study show that there is significant reduction in serum AMH in infertile men (1.40 ± 0.11 ng/ml), as compare with fertile men, (4.17 ± 0.67). However, regarding serum prolactin, there is no significant differences between infertile men (4.26 ± 2.17 ng/ml) as compare with control fertile men (3.91± 1.52).Conclusion & Recommendation: The present study concludes that there is significant reduction in serum testosterone & AMH of infertile men as compare with fertile men. However, there is significant increase in serum FSH & LH in infertile men. There is negative correlation between AMH & serum testosterone in infertile men. The present study recommend the followings;-Proper selection of patients with respect to hormonal assays which reduces the costs and burden on the infertile patients, & the routine assessment of thyroid hormones and antibodies in infertile men are not recommended.