Predictive significance of serum inhibin B on testicular haploid gamete retrieval outcomes in nonobstructive azoospermic men

The purpose of this study was to determine the diagnostic accuracy of serum inhibin B(INHB)as a predictor of the retrieval outcome of testicular haploid gametes(spermatids and testicular spermatozoa)in nonobstructive azoospermic men.Serum hormone levels,testicular volume,and histological evaluation were performed in 403 Chin ese non obstructive azoospermic men.Testicular haploid gamete was successfully retrieved in 213 of 403 patients(52.85%).The haploid gamete group always had higher INHB levels than the non-haploid gamete group.According to the receiver operating characteristic(ROC)curve analysis,INHB was a good predictor of testicular haploid gamete retrieval outcome in all patients(sensitivity:77.93%and specificity:91.58%)and patients with normal follicle-stimulating hormone(FSH;sensitivity:88.52%and specificity:70.83%).The area under the ROC curve(AUC)of INHB was similar to that of FSH in all patients or patients with normal FSH.In patients with elevated FSH,INHB was superior to FSH in predicting the presence of haploid gamete(AUC:0.73 vs 0.55,P<0.05),with a sensitivity of 60.00%and a specificity of 80.28%.It con eluded that serum INHB as an effective marker for spermatoge nesis was a sign ificant predictor of testicular haploid gamete retrieval outcomes in nonobstructive azoospermic men.Especially,INHB is superior to FSH in predicting the presenee of haploid gamete in the patients with elevated FSH.

Mutational analysis of the GATA4 gene in Chinese men with nonobstructive azoospermia

As a crucial transcription factor for spermatogenesis,GATA-binding protein 4(GATA4)plays important roles in the functioning of Sertoli and Leydig cells.Conditional knockout of GATA4 in mice results in age-dependent testicular atrophy and loss of fertility.However,whether GATA4 is associated with human azoospermia has not been reported.Herein,we analyzed the GATA4 gene by direct sequencing of samples obtained from 184 Chinese men with idiopathic nonobstructive azoospermia(NOA).We identified a missense mutation(c.191G>A,p.G64E),nine single-nucleotide polymorphisms(SNPs),and one rare variant(c.^(*)84C>T)in the 3′untranslated region(UTR).Functional studies demonstrated that the p.G64E mutation did not affect transactivation ability of GATA4 for spermatogenesis-related genes(claudin-11 and steroidogenic acute regulatory protein,Star),and the 3′UTR rare variant c.^(*)84C>T did not generate microRNA-binding sites to repress GATA4 expression.To our knowledge,this is the first report to investigate the association between GATA4 and azoospermia;our results indicate that mutations in GATA4 may not be pathogenic for NOA in Chinese men.