Age and education influence the performance of elderly women on the dual-task Timed Up and Go test / Idade e educação influenciam o desempenho de mulheres idosas no teste Timed Up and Go com dupla tarefa

Gait variability is related to functional decline in the elderly. The dual-task Timed Up and Go Test (TUG-DT) reflects the performance in daily activities. Objective To evaluate the differences in time to perform the TUG with and without DT in elderly women with different ages and levels of education and physical activity. Method Ninety-two elderly women perfomed the TUG at usual and fast speeds, with and without motor and cognitive DT. Results Increases in the time to perform the TUG-DT were observed at older ages and lower educational levels, but not at different levels of physical activity. More educated women performed the test faster with and without DT at both speeds. When age was considered, significant differences were found only for the TUG-DT at both speeds. Conclusion Younger women with higher education levels demonstrated better performances on the TUG-DT. .

Alterações da marcha são indícios de declínio funcional em idosos. O TUG com dupla tarefa (TUG-DT) reflete o desempenho das atividades do cotidiano. Objetivo Avaliar as diferenças no tempo de execução do TUG com e sem DT em idosas com diferentes faixas etárias, e níveis de escolaridade e atividade física. Método Noventa e duas idosas foram avaliadas pelo TUG nas velocidades usual e máxima, sem e com DT cognitiva e motora. Resultados Houve aumento no tempo de execução do TUG-DT em idosas com maior faixa etária e menor escolaridade, mas não para diferentes níveis de atividade física. Aquelas com maior escolaridade realizaram o teste mais rápido com e sem DT nas duas velocidades. Com relação à faixa etária, foram obervadas diferenças apenas nos testes com DT nas duas velocidades. Conclusão Idosas mais jovens com maior escolaridade demonstraram um melhor desempenho no TUG com DT. .

Serum inhibin B as a marker of spermatogenesis

Serum inhibin B has emerged as a good marker of spermatogenesis and Sertoli cell function. The aim of this study was to better define the relationship between serum inhibin B level with serum follicle stimulating hormone [FSH] and the spermatogenetic function of the testis in fertile and infertile men and to evaluate the diagnostic value of inhibin B in the management of male infertility. Fifty-five infertile men [age ranged from 22-40 years with a mean of 30.4 +/- 3.2 years] were included in this study. They were divided into 3 groups; the first group was composed of 20 oligozoospermic patients [sperm concentration<20 millionl ml], the second group included 18 azoospermic patients with functional etiology, and the third group included 17 azoospermic patients with obstructive causes. Also a control group of 20 fertile subjects of comparable age was included. Andrology Outpatient Clinic, Menoufyia University Hospitals. Inhibin B and FSH were assessed in serum, semen analysis and testicular volume estimation were performed for studied and control subjects. Also testicular biopsy was done for azoospermic cases only. Mean serum inhibin B level in fertile subjects was 201.2 +/- 37.5 pg/ml, which was almost similar to the mean level in patients with azoospermia due to obstructive causes [199.2 +/- 30.5pg/ ml], while the mean level was significantly reduced in oligozoospermic patients [104.5 +/- 15.4 pg/mI] and in patients with functional azoospermia [45.3 +/- 26.2 pg/ml][P<0.0001]. Also, it was noticed that there was a positive correlation between serum inhibin B and sperm concentration, testicular volume and Johnsen's scores of testicular biopsy, while there was a negative correlation with FSH levels. It is concluded that serum inhibin B is an index of global testicular function whose secretion reflects a fundamental interaction between Sertoli cells, germ cells and FSH. Thus its measurement can offer improved diagnosis of testicular dysfunction

Performance Characteristics of the UniCel DxI 800 Immunoassay for the Maternal Serum Quadruple Test, Including Median Values for Each Week of Gestation, in Korean Women / 대한진단검사의학회지

BACKGROUND: Maternal serum prenatal quadruple screening includes testing for alpha-fetoprotein (AFP), human chorionic gonadotrophin (hCG), unconjugated estriol (uE3), and dimeric inhibin A (DIA). We evaluated quadruple screening using an automated platform and looked for any ethnic differences in the median values of each marker. METHODS: We measured the concentrations of each quadruple test analyte using the UniCel DxI 800 system (Beckman Coulter, USA) in 788 Korean mid-trimester maternal serum samples and calculated their median values using Benetech software (Benetech, Canada). We also compared the results with those obtained using the Immulite 2000 assay (Siemens Healthcare Diagnostics, USA) or ELISA (DSL, USA) in 442 samples. RESULTS: We obtained mid-trimester median values for each marker. The following are the comparative results for each test using the Immulite 2000 assay or ELISA (x) and the UniCel DxI 800 immunoassay (y): AFP, y=1.10x+0.01, r=0.925; uE3, y=0.28x+0.24, r=0.885; hCG, y=1.22x-3047.8, r=0.944; and DIA, y=0.86x+15.31, r=0.833. Assay results for each of the four markers showed good correlations. However, significant biases necessitated new median calculations of prenatal risk estimates in all four tests. CONCLUSIONS: We established gestational age-specific second-trimester median values for four markers in Korean samples using the UniCel DxI 800 immunoassay system. Despite significant bias, there were good correlations between the results obtained using the UniCel DxI 800 immunoassay and those obtained using the Immulite 2000 assay.

Aplicações das dosagens de inibinas em Ginecologia e Obstetrícia / Clinical usefulness of inhibin assays in Gynecology and Obstetrics

Na mulher, a principal fonte de inibina B são as células da granulosa de folículos em crescimento, enquanto a inibina A é secretada principalmente pelo corpo lúteo e pela placenta. Em mulheres inférteis submetidas a terapias de reprodução assistida, a inibina B se mostrou útil para predizer má resposta ovulatória, embora não tenha superado o desempenho de outros marcadores. No rastreamento pré-natal da síndrome de Down, a utilidade da inibina A foi repetidamente confirmada no segundo trimestre e começa a ser considerada também na bateria de testes do primeiro trimestre. Além das duas aplicações acima, a dosagem de inibina total pode contribuir para a identificação de casos de insuficiência ovariana autoimune. A inibina total também pode ser um marcador auxiliar no diagnóstico de tumores epiteliais do ovário, enquanto a dosagem de inibina B auxilia no diagnóstico de tumores de células da granulosa. O uso da inibina A pode se estender à avaliação de gestantes com ameaça de abortamento, com história de abortamento de repetição, com risco aumentado de pré-eclâmpsia, ou ainda nos primeiros dias de seguimento pós-esvaziamento de mola hidatiforme. Todas essas aplicações continuam em estudo, mas com possibilidade real de virem a ampliar o espectro diagnóstico das dosagens de inibinas em Ginecologia e Obstetrícia.

The main source of inhibin B in women is the growing follicle granulosa cells, while inhibin A is mainly produced by the corpus luteum and the placenta. In infertile women submitted to therapies of assisted reproduction, inhibin B has shown to be useful to predict a poor ovulatory response, though it has not yet overcome the performance of other markers. In the pre-natal screening of the Down syndrome, inhibin A has been repeatedly confirmed as useful in the second trimester and has also started to be considered in the first trimester test battery. Besides the two applications above, the dosage of total inhibin may contribute to the identification of cases of autoimmune ovarian insufficiency. Total inhibin may also be an auxiliary marker in the diagnosis of ovarian epithelial tumors, while the amount of inhibin B helps in the diagnosis of granulosa cells tumors. The use of inhibin A may be extended to the evaluation of pregnant women with risk of abortion, with a history of repeated abortion, with increased risk of pre-eclampsia, or even in the first days of follow-up of hydatiform mole post-emptying. All those applications are still under study, but with a real possibility of helping to extend the diagnostic spectrum of inhibin dosage in Gynecology and Obstetrics.

Role of inhibin B as a marker of spermatogenesis in infertile patients with varicocele

Varicocele is a state of varicosity and tortousity of the pampiniform plexus around the retrograde blood flow. There is strong association between varicocele and subfertility so treating varicocele may be helping improvement of fertility. Inhibin B levels reflect the functional state of seminiferous epithelium and have been considered as sensitive index of spermatogenesis. This study was to detect the role of serum inhibin B concentration in infertile men with varicocele before and after varicocelectomy. Twenty patients with varicocele were included in this study. Serum inhibin B, serum FSH and semen analysis were performed before and after 6 months after varicocelectomy. There was a significant increase of inhibin B levels [P < 0.01] after varicocelectomy and a significant decrease of serum FSH levels was observed after surgery P < 0.01]. A significant improvement of semen analysis, sperm concentration [P < 0.01] and progressive motility [P < 0.05] was showed after treatment. Serum Inhibin B level in infertile men may provide a useful information about spermatogenesis and could be used as a more direct marker of spermatogenesis than FSH. Moreover, varicocelectomy improves the level of inhibin B and semen parameters in those patients

Value of serum and synovial fluid activin A and inhibin A in some rheumatic diseases

Activin is a growth and differentiation factor of many cell types and has recently been implanted in inflammatory processes. Clinical data demonstrating roles of activin and its antagonist inhibin in inflammatory arthropathies, are lacking. The Study is to measure serum and synovial fluid levels of activin A and inhibin A in patients with rheumatoid arthritis [RA] systemic lupus erythematosus [SLE] and osteoarthritis [OA] and correlate them with disease activity parameters. This study included 60 patients with three rheumatic diseases [20 with RA, 20 with SLE and 20 with OA], as well as ten healthy subjects as a control group. All of them were subjected to complete history, physical and musculoskeletal examination and estimation of disease activity index [DAS- 28] for RA and [SLEDAI] for SLE. The following investigations were done for all subjects; serum and synovial activin A and inhibin A; in addition to complete blood picture, erythrocyte sedimentation rate [ESR], C-reactive protein [CRP],rheumatoid factor [RF], antinuclear antibodies [ANA],anti-dsDNA, serum complement [C 3, 4] and Xrays on affected joints. The mean values of serum activin A were significantly higher in RA, SLE and OA than controls [P<0.001] also in RA and SLE versus OA [P<0.05 for both]. The mean values of serum inhibin A were significantly higher in all studied groups than controls [P<0.05 for RA and OA and P<0.001 for SLE]. Also serum inhibin levels were significantly higher in SLE versus OA P<0.001, but there was no significant differences between RA and SLE. Synovial fluid activin and inhibin A were significantly higher in RA than OA [P<0.05 for both]. Positive correlations were found between serum activin A and disease activity parameters of RA morning stiffness [MS], Ritchie index [RI], ESR, CRP and DAS 28] P<0.05, for all. Also positive correlation was found between serum inhibin A and RI in RA patient [P<0.05]. In SLE, positive correlations were found between serum activin A and inhibin A with ESR [P<0.001 for activin and P<0.05 for inhibin A and SLEDAI [P<0.001 for both activin and inhibin]. No correlation were found between synovial activin and disease activity and negative correlation between synovial inhibin and ESR. The significant increase of serum and synovial activin A and inhibin A in RA and SLE and their positive correlations with disease activity parameters of RA and SLE suggest pro-inflammatory action. However the lack of correlations or negative correlation of their synovial levels with disease activity may indicate their anti inflammatory action, We recommended further studies to detect the exact role of activin A and inhibin A

Predictive value of maternal hormonal serum level of inhibin a in case of threatened abortion

Threatened abortion is the commonest complication in pregnancy, it is defined as vaginal bleeding with or without menstrual like cramps in the first 20 weeks of pregnancy. No history of passage of tissue or rupture of membrane is present and ultrasound demonstrates an intrauterine sac with fetal cardiac activity. The early and accurate prediction of unsuccessful pregnancy in this situation should lead to appropriate treatment without unnecessary delay, but still there is no efhctive marker to predict in advance the outcome of threatened abortion. Inhibin A concentration rises and falls during the menstrual cycle. The lowest level is during the early and late days of the cycle and peaks during midcyles coincident with LH surge and midlureal period [being twofold higher than the first]. its level is higher in pregnant women than in non pregnant, and increases throughout pregnancy until delivery. in the early weeks of gestation, the corpus luteum is the principal source of inhibin but about the eighth week, it is excreted from the fetoplacental unit, immediately after delivery it's level decreases sharply. Th aim of the present research was to study the possible role of inhibin A in predicting pregnancy outcome in women with threatened abortion. This study included fifty pregnant women at 8 and 10 weeks gestational age, they were divided into: Groujy I [studied group] including 30 pregnant women with threatened abortion. Group II [control group] including 20 healthy not complaining pregnant women matched with the studied group. All of them were subjected to the following: Complete history taking, general clinical examination; obstetric examination; routine laboratory investigations; ultrasound examination for detection of fetal viability and fetal parameters; maternal blood samples were collected for determination of the quantitative measurement of inhibin A and follow up of cases till reaching 20 weeks of gestational age. The studied groups were further subdivided according to the outcome of pregnancy into: Group A [threatened abortion and fluting pregnancies] n 15; group B [threatened abortion bui ongoing pregnancies] n 15. The results of the study were analysed statistically, and we found that; there was a significant decrease in the levels of inhibin A in cases of threatened abortion [group I] compared with the control group. Much more significant lower levels of inhibin A were Jbund in cases of threatened abortion and failing pregnancies [group A] compared with the cases of threatened abortion but ongoing pregnancies [group B]. The cutoff value of inhibin A was measured, using the receiving operator curve [Roc curve], it was 268.9 pg/mI with a sensitivity of 82.5% and a specificity of 90.1% at8 weeks, while it was 395.5 pg/mI with a sensitivity of 85.5% undo specificity of 90.5% at 10 weeks. From our study we concluded that, finding an abnormal low level of inhibin A in pregnant fimale with threatened abortion can predict poor pregnancy outcome. The expanding knowledge of the role of inhibins since the development of specific and sensitive assays has opened the field for their potential uses in clinical practice. Examining the role of inhib ins and other biochemical markers in early pregnancy ftzilure will lead to an improved understanding of the mechanism behind it and will aid in selection of patients in whom expectant management is appropriate

Analysis of Serum Levels of Anti-Mullerian Hormone, Inhibin B, Insulin-Like Growth Factor-I, Insulin-Like Growth Factor Binding Protein-3, and Follicle-Stimulating Hormone with Respect to Age and Menopausal Status

This study was undertaken to investigate age-dependent and postmenopausal changes in the serum levels of anti-Mullerian hormone (AMH), inhibin B, insulin-like growth factor (IGF)-I, IGF-binding protein-3 (IGFBP-3), and follicle-stimulating hormone (FSH), and to determine which of these markers best reflects the aging process in women. A total of 144 women aged 20-59 yr were enrolled in this cross-sectional study. Blood samples were obtained on cycle day 3 of regularly menstruating women (n=111), or at random in postmenopausal women (n=33). Data were analyzed with respect to premenopausal women age groups and compared in pre- and postmenopausal women. Area under the receiver operating characteristic curve (ROCAUC) analyses were performed to assess the ability of each marker to discriminate between the pre- and postmenopausal status. Serum levels of AMH, IGF-I, and IGFBP-3 decreased and serum levels of FSH increased significantly with age in premenopausal women. Serum luteinizing hormone (LH) was higher and inhibin B was lower in women in their 20-30's than in 40's. Serum levels of AMH and IGF-I showed a consistent decrease with all age groups. ROCAUC analysis showed that the diagnostic accuracy of AMH for menopausal status was similar to those of FSH, LH, and inhibin B, and was better than that of IGF-I. In conclusion, the serum AMH level appears to be the best marker of the aging process in premenopausal women.

Serum Anti-Mullerian Hormone and Inhibin B Levels at Ovulation Triggering Day Can Predict the Number of Immature Oocytes Retrieved in In Vitro Fertilization Cycles

The aim of this study was to investigate whether serum levels of anti-Mullerian hormone (AMH) and inhibin B at ovulation triggering day correlate with the number of immature oocytes obtained from stimulated in vitro fertilization (IVF) cycles. Fiftynine consecutive cycles of ovarian hyperstimulation and IVF were selected from 45 women who had tubal (n=18) or unexplained infertility (n=27) and obtained at least one oocyte. Serum levels of AMH and inhibin B at ovulation triggering day were measured by enzyme-linked immunosorbent assay (ELISA). Univariate analysis and multiple regressions revealed that serum AMH or inhibin B levels were significantly correlated with immature oocyte count and the correlation coefficients were higher compared to the mature oocyte count. Serum AMH and inhibin B levels on triggering day seems to be more closely related with the immature oocyte count and thus could be good predictors to determine the immature oocyte count in IVF cycle.

Effect of melatonin on some bone turnover markers in ovarectomized rats

This study was carried out to evaluate the effect and the mechanism of action of melatonin on some bone markers in ovarectomized bone loss in rats. 32 female albino rats underwent either bilateral laparotomy [sham, n=8] or bilateral ovarectomy [Ovx, n=24]. The Ovx rats were divided into 3 groups, each of 8 rats; Vehicle-treated [Ovx], estrogen-treated [E2] and melatonin-treated [Mlt] group. After 14 weeks treatment, blood and urine were collected. Serum osteoprotegerin [OPG], inhibin, follistatin, and alkaline phosphatase [ALPase] were determined as bone markers. In addition, urinary Deoxypyridinoline [uDPD] was assayed. Serum OPG, inhibin and follistatin levels significantly decreased upon Ovx. They increased upon either treatment with E2 or Mlt with non- significant difference in between as compared to Ovx group. In addition, serum ALPase and uDPD significantly increased on Ovx and decreased with either therapy as compared to Ovx one with non- significant difference between both therapies. The results revealed that administration of Mlt inhibited high bone turnover and prevented calcium loss in ovarectomized rats. This may be through increasing OPG, inhibin and/or follistatin levels. Mlt could be a candidate for the treatment of postmenopausal osteoporosis

Comparison of the prognostic values of inhibin and CA-125 as tumour markers for ovarian masses diagnosed by ultrasonography

To evaluate the performance of screening for ovarian malignancy by serum assay of inhibin and cancer antigen [CA-125] in patients with ultrasonographically diagnosed ovarian masses. Their predictive efficacy as tumour markers will also be assessed. Two-year observational, cross-section study of screening performance. Al-Azhar University Hospitals in Damietta and Cairo. 60-women with ovarian masses larger than 10cm were enrolled in this study. All patients were subjected to a complete medical history, clinical and ultrasonographic examinations. Laboratory assay of serum inhibin and CA-125 were performed before surgical procedure and repeated at 3-week and 6-month postoperative visits. All ovarian specimens were examined histopathologically. Mean concentrations of serum inhibin and CA-125. The mean concentrations of serum inhibin and CA-125 declined significantly in patients with benign ovarian masses at 3-week and 6-month follow-up visits in comparison with baseline concentrations [8.01 +/- 3.91 and 7.07 +/- 3.22 vs 14.30 +/- 5.42pg/mL; 24.60 +/- 5.19 and 24.30 +/- 10.72 vs 32.10 +/- 10.41U/mL, respectively]. [p+<0.05]. It was evident that the mean concentrations of serum inhibin and CA-125 were significantly higher in patients with malignant ovarian masses than in those with benign ovarian masses [p*<0.001]. In malignant ovarian mass group, there was a significant reduction of serum inhibin and CA-125 at 3-week and 6-month follow up visits in comparison with the baseline concentrations [21.60 +/- 2.35 and 21.60 +/- 3.07 vs 58.10 +/- 20.62pg/mL; 34.31 +/- 11.56 and 33.32 +/- 12.50 vs 69.81 +/- 27.72U/mL, respectively] [p+<0.05] The serum levels of inhibin and CA-125 were significantly higher in patients with endometrioid cysts than that in patients with other benign ovarian tumours [p<0.05]. In addition, the mean concentrations of serum inhibin and CA-125 were significantly higher in patients with dysgerminoma [82.70 +/- 21.20pg/mL and 63.52 +/- 15.90U/mL, respectively] compared with other pathological types of malignant ovarian tumours [p<0.05]. Considering the predictive efficacy of the studied tumour markers, elevated serum levels of inhibin and CA-125 could predict ovarian malignancy with a sensitivity of [82% vs 85%], specificity of [85% vs 78%], positive predictive value of [87% vs 82%], and negative predictive value of [79% vs 81%], respectively [p>0.05]. Screening modality of plasma inhibin assay has been proven to be efficacious as a tumour marker for ovarian malignancy. It has a predictive efficacy comparable to that of CA-125. Their use together could potentially improve sensitivity and specificity in screening for ovarian cancer

Prediction of successful sperm retrieval in patients with nonobstructive azoospermia

Our aim was to evaluate the predictive values of factors that indicate successful sperm retrieval in men with nonobstructive azoospermia. We evaluated 85 infertile men with nonobstructive azoospermia who underwent multiple bilateral testicular biopsies. Factors including age, infertility period, surgical history, testicular volume, testicular consistency, serum follicle-stimulating hormone [FSH], serum inhibin B, serum luteinizing hormone, and serum total testosterone were assessed in relation to sperm retrieval results. Spermatozoa were retrieved in 18 biopsies [21.2%]. Follicle-stimulating hormone, serum inhibin B, and testicular volume were associated with the results of sperm retrieval. Men with a higher testicular volume, a higher serum inhibin B, and a lower FSH had successful sperm retrieval. The cutoff points were determined as 9.5 mL for testicular volume, 9.9 IU/L for serum FSH, and 39.8 pg/mL for serum inhibin B. These 3 factors had strong correlations with each other. The sensitivities and specificities were 88.9% and 94% for testicular volume, 97% and 83.3% for FSH, and 72.2% and 95.5% for serum inhibin B, respectively. The positive predictive value for a combination of serum FSH and inhibin B was 100%. Serum FSH and serum inhibin B are useful markers for evaluation of the presence of sperm in patients with nonobstructive azoospermia. Inhibin B has a high specificity when combined with serum FSH and their measurements can be helpful in all patients with nonobstructive azoospermia before decision making for sperm retrieval

correlation of serum inhibin with sperm count and sperm motility in fertile and infertile males

Inhibin is produced by Sertoli cells of the testis, provides negative feedback on FSH secretion, and may prove to be an important marker for the functioning of seminiferous tubules. The purpose of this study was to examine the relationship between the spermatogenic function of the tests of subfertile men and the plasma concentrations of inhibin. The study was carried out on twenty infertile [or subfertile] males and ten age-matched control subjects with proven fertility. Infertile subjects were subdivided into oligospermie, normospermie and azoospermic on the basis of their sperm count. In infertile subjects mean serum inhibin concentration [30.4 +/- 22.2 pg/ml] was higher as compared to fertile subjects [25.2 +/- 8.5 pg/ml], although the difference was not statistically significant [p > 0.05]. Among the subgroups of infertile subjects mean serum inhibin level in azoospermics, who showed testicular atrophy on biopsy, was 8.2. +/- 1.1 pg/ml, which was significantly lower [p < 0.002] than fertile subject. The mean sperm count of infertile subjects way significantly lower than fertile subjects [p < 0.01]. The mean percentage of progressively active sperm was significantly lower in infertile than fertile subject [p > 0.001] while mean percentage of immotile sperms was significantly higher in infertile than fertile subjects [p < 0.001]. Sluggishly motile sperms did not show a significant difference between two groups. No significant correlation of serum inhibin with either sperm count or sperm motility was observed in both, fertile as well as infertile subjects. These results indicate that serum inhibin concentration is decreased in case of damage to the seminiferous tubules, however absence of any correlation of serum inhibin with sperm count and sperm motility questions its validity in place of traditional parameters used, for assessment of male infertility

Serum inhibin B level in adolescent female IDDM

Patient with insulin dependant diabetes mellitus [IDDM] are liable to changes in the control of release of prolactin, lutenizing hormone [LH], and follicle stimulating hormone [FSH]. These changes may be due to altered hypothalamus-pituitary regulating mechanism. Inhibin is a peptide member of transforming growth factor family [TGF beta]. It is secreted by granulose and theca cells of the ovary. Its secretion from granulose cells is stimulated by FSH. The aim of the present work is to spotlight the exocrine and endocrine function in female adolescent with IDDM.20 adolescent female patients with IDDM [their ages ranging from I Ito 16 years] were subjected to history taking, clinical evaluation, serum estradio and FSH, LH and inhibin B level. Our patients showed no significant difference as regards serum estradiol, FSH, LH and serum inhibin B level when compared with the control group. Whereas serum level of some hormones [FSH, LH and inhibin B] were significantly increase in 10DM patients with regular menstrual cycles when compared with the 10DM patients with irregular menstrual cycles. No significant difference between the control group and IDDM patient with good, moderate or poor metabolic control were found as regards serum estradiol level, FSH, LH and serum inhibin B level. We conclude that our young diabetic females after mean disease duration of 9 years and various metabolic control, had serum inhibin B and gonadotropins comparable to those of normal subjects. Therefore they seem to have a regular ovarian function and in particular granulosa and theca cells despite of sustained hyperglycemia

Ovulation prediction in spontaneous and induced cycles: the role ovarian reserve markers

To evaluate the role of day 3; serum FSH, inhibin-B, estradiol, [biochemical markers], ultrasound measured antral follicle count AFC and ovarian volume OV. [biophysical markers]; as static screening markers of the ovarian reserve in ovulation prediction in induced cycles in infertile patients with different induction protocols; as dynamic performance tests compared to spontaneous cycles in matched fertile patients. Also, to analyze the correlations between these markers and prediction of ovulation success in induced cycles with different induction protocols. Prospective comparative controlled study. Infertility Clinic, University Hospital, El Minia and private IVF center, Egypt. Eighty infertile patients [study group] classified into four subgroups, twenty patients each according to the method of ovulation induction and twenty matched fertile subjects [control group]. Day 3; serum inhibin-B, FSH, estradiol were measured together with transvaginal ultrasound measurements of the antral follicle count and ovarian volume in the study and the control groups. The study group was subdivided into four subgroups according the method of ovulation induction; whether clomiphene citrate [group I], or human menopausal gonadotropine [group II], or low dose follicle stimulating hormone [group III] or long IVF protocol [group IV]. The predictive values of different screening markers in relation to ovulation. Other outcome measures were ovulation rate as detected by progesterone measurement in day 21 of the cycle together with analysis of the correlations between various biochemical and biophysical markers and prediction of ovulation success in induced cycles with different induction protocols. The predictive values [sensitivity, specificity, positive predictive value, negative predictive value and accuracy] in relation to ovulation prediction of FSH [< 10 IU/L] were [96.66, 60.00, 95.60, 66.66 and 93.00%, respectively], serum inhibin-B [> 45 pg/ml] were [97.77, 70.00, 96.70, 77.77 and 95.00%, respectively], estradiol [< 75 pg/ml] were [96.59, 75.00, 96.59, 75.00 and 94.00%, respectively] AFC [> 6] were [97.77, 70.00, 96.70, 77.77 and 95.00%, respectively], and OV [> 3 cm][3] were [96.66, 60.00, 95.66, 66.66 and 93.00%, respectively]. Multivariate analysis of the variables that predict ovulation in induced cycles demonstrated that; of the biochemical variables FSH was the most significant contributor to ovulation [R2 = 0.93, P,

Day 3 serum inhibin B level of poor and good ovarian responders in the IVF-program.

The aim of this study was to compare day-3 serum inhibin B levels of poor and good ovarian responders in the IVF-program. The study group consisted of 20 poor ovarian responders. The control group composed of 40 good ovarian responders who had similar demographic characteristics. The serum inhibin B levels were analysed by two-site-immunosorbent assay or sandwich ELISA (Enzyme Linked ImmunoSorbent Assay). The mean inhibin B level of the study group was 113.18 +/- 57.96 picogram per millilitre and of the control group was 94.05 +/- 61.81 picogram per millilitre. There was no statistically significant difference. The results might be useful as base-line data for further study.

Utilidad de la relación entre la hormona estimulante del folículo, la deoxipiridinolina, el estradiol y la inhibina como criterio de decisión para el inicio de la terapia hormonal de reemplazo en el climaterio y su correlación con la sintomatología / Utility of relation between follicle stimulating hormone, estradiol, estrone and inhibin as decision criteria for starting hormone replacement theraphy in climatery and its correlation to symptoms

Introducción. no existe forma de indicar con precisión cuál es el momento más adecuado para iniciar la terapia hormonal de reemplazo (THR). Objetivo. evaluar diversos índices obtenidos por medio de las concentraciones séricas de hormona estimulante del folículo (FSH), estradiol (E2), estrona (E) e inhibina en suero y urinarias de decisión para el inicio de la THR en el climaterio. Material y métodos. A 53 pacientes se les evaluó la presencia e intensidad de los síntomas climatéricos por medio del índice de Kupperman modificado. Se dividieron en: premenopáusicas, perimenopáusicas o posmenopáusicas. Se les realizaron determinaciones sanguíneas de FSH, E2, E e inhibina, y DPD en orina. Se calcularon diversos índices, se compararon entre los grupos y se correlacionaron con la puntuación obtenida en el índice de Kupperman. Análisis estadístico. Se realizaron pruebas de Kruskall-Wallis y U de Mann-Whitney, así como análisis de correlación de Spearman. Resultados. Al comparar los diversos índices, el índice Log FSH/E2, Log FSH/E2/E, Log FSH(DPD)/E2, Log FSH (DPD)/E2/E y Log FSH(DPD)/Inhi-bina(E2) fueron significativamente mayores en el grupo de posmenopáusicas. Sólo hubo correlación significativa entre el índice Log FSH/Inhibina(E2) y el índice Log FSH (DPD)/Inhibina(E2) con el índice de Kupperman. Conclusiones. De los índices calculados el que parece ser el mejor marcador es la relación Log FSH(DPD)/E2/E, ya que tuvo un incremento progresivo conforme las pacientes avanzaban hacia la posmenopausia. El índice antes mencionado deberá validarse con un número mayor de pacientes, para poder definir un punto de corte a partir de que se pueda indicar a cuáles pacientes se debe administrar la THR.

Inhibin B, A putative marker of spermatogenesis: its value in assessment of patients with varicocele

This study was an attempt to evaluate the significance of estimating serum levels of inhibin B among different categories of varicocele patients, to find out the relationship between thin protein and serum levels of FSH as well as sperm parameters and to detect the influence of varicocelectomy on this protein. Serum levels of inhibin B for 48 patients with varicocele were studied in comparison with 20 healthy fertile non-varicocele controls using a one-step two- site ELISA technique. It was found that serum inhibin B levels for patients with varicocele were significantly lower than that of fertile non- varicocele men and were not correlated with serum FSH levels or sperm parameters. Varicocelectomy restored the serum levels of inhibin B to its normal values that was associated with a significant improvement of seminal parameters

Inibina-A no soro materno no segundo trimestre gestacional: um novo marcador bioquímico de síndrome de Down / Second-trimester maternal serum inhibin-A: a new biochemical marker of Down's syndrome

As inibinas säo hormônios glicoproteícos que durante a gravidez, säo sintetizados, principalmente, pela placenta. A inibina-A é a principal forma dimérica circulante durante este período. Este hormônio vem sendo incluído no teste combinado de rastreamento da síndrome de Down por marcadores bioquímicos de soro materno, por aumentar a taxa de detecçäo. Nosso estudo abrangeu a dosagem de inibina-A em 160 amostras de soro materno utilizando-se um ensaio imunoenzimático do tipo sanduíche, de média sensibilidade. Verificamos que os níveis de inibina-A säo constantes ao longo do segundo trimestre gestacional, como já havia constatado por outros autores anteriormente. Encontramos uma correlaçäo positiva entre os níveis de inibina-A e os de Beta-hcg (p=0,0001). O peso materno e a inibina-A sérica mostraram uma correlaçäo negativa (p=0,0023). Näo foi observada correlaçäo estatisticamente signicativa dos valores de inibina-A com níveis de AFP e uE3. Nossos dados foram comparados com aqueles encontrados na literatura médica. Este estudo nos permitirá incluir mais este marcador em nosso esquema de rastreamento pré-natal de síndrome de Down