Mp18-05 inhibin b/fsh ratio as a predictor of abnormal semen analysis in adolescent boys with palpable varicocele

You have accessJournal of UrologyCME1 Apr 2023MP18-05 INHIBIN B/FSH RATIO AS A PREDICTOR OF ABNORMAL SEMEN ANALYSIS IN ADOLESCENT BOYS WITH PALPABLE VARICOCELE Karl Godlewski, Sameer Mittal, Juliana Arenas, Nathan Hyacinthe, Emily Ai, Tyler Gaines, Katherine Fischer, Jason van Batavia, and Thomas Kolon Karl GodlewskiKarl Godlewski More articles by this author , Sameer MittalSameer Mittal More articles by this author , Juliana ArenasJuliana Arenas More articles by this author , Nathan HyacintheNathan Hyacinthe More articles by this author , Emily AiEmily Ai More articles by this author , Tyler GainesTyler Gaines More articles by this author , Katherine FischerKatherine Fischer More articles by this author , Jason van BataviaJason van Batavia More articles by this author , and Thomas KolonThomas Kolon More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003238.05AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Fertility potential in adolescent boys with varicocele is best assessed with semen analysis (SA), however a SA can be difficult to obtain in some patients. Surrogates for abnormal SA, such as FSH and Inhibin B, have been investigated to potentially circumvent the barriers related to boys obtaining SA. Recent reports note the Inhibin B/FSH ratio may have good predictive value of testis health in adult varicoceles and infantile undescended testes. We hypothesize that Inhibin B/FSH ratio is a better predictor than FSH or Inhibin B alone in identifying abnormal SA in adolescent boys with left varicocele. METHODS: We queried our IRB-approved varicocele registry to identify Tanner V boys with palpable varicocele, SA and serum hormonal labs (FSH, Inhibin B) within 12 months of the SA. Abnormal SA was defined as TMC<9 million. ROC analysis was used to determine how well hormone levels (FSH, Inhibin B and Inhibin B/FSH ratio) could predict abnormal SA. Optimal cutoffs were calculated using the Youden index (J). RESULTS: Of 2158 patients in our registry, 192 Tanner V boys with palpable varicocele, SA, and hormone labs were included. Overall mean age was 17.2 years. Significant differences were noted in mean Inhibin B (226 vs 173; p=0.001), median FSH (3.3 vs 4.9; p=0.001), median TMC (37 vs 3.1; p=0.001), and median Inhibin B/FSH ratio (69 vs 32; p=0.001) between boys with normal and abnormal SA, respectively [Table 1]. ROC curves were generated to determine optimal cutoffs for FSH, Inhibin B, and Inhibin B/FSH ratio to predict abnormal SA [Figure 1]. Inhibin B/FSH ratio showed the highest AUC (0.66, sensitivity 71% specificity 61%.) overall at a cutoff of 53. CONCLUSIONS: In our analysis of adolescent patients with palpable varicocele, Inhibin B/FSH ratio does appear to be a better predictor of abnormal SA (TMC<9mil) than FSH or Inhibin B alone. Despite there being a clear correlation between all three markers and abnormal SA, the mediocre AUC’s of 0.65 – 0.66 for each respective cutoff, make clinical decision making solely on markers difficult. Source of Funding: - © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e224 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Karl Godlewski More articles by this author Sameer Mittal More articles by this author Juliana Arenas More articles by this author Nathan Hyacinthe More articles by this author Emily Ai More articles by this author Tyler Gaines More articles by this author Katherine Fischer More articles by this author Jason van Batavia More articles by this author Thomas Kolon More articles by this author Expand All Advertisement PDF downloadLoading ...