Altered serum profile of inhibin B, Pro-alphaC and anti-Müllerian hormone in prepubertal and pubertal boys with varicocele.

OBJECTIVE: Anti-Müllerian hormone (AMH) and inhibin B are reliable markers of Sertoli cell function. The aim of the present study was to assess the functional state of Sertoli cells in order to detect early changes in the testicular function of prepubertal and pubertal patients with untreated grade II or III varicocele.

DESIGN AND PATIENTS: Seven prepubertal and 55 pubertal boys with untreated grade II or III varicocele were studied. Seven prepubertal and 43 pubertal normal boys were considered as controls.

MEASUREMENTS: Serum levels of gonadotrophins, testosterone, inhibin B and Pro-alphaC and AMH were determined by time-resolved immunofluorometric assays, radioimmunoassay (RIA) and specific enzyme-linked immunosorbent assays (ELISAs), respectively.

RESULTS: Inhibin B and Pro-alphaC serum levels were higher in prepubertal patients with varicocele than in controls (P < 0.001). No further increment in inhibin B and Pro-alphaC levels was observed in pubertal patients with varicocele. Higher levels of AMH were found in patients in Tanner stages I, III, IV and V when compared to normal boys by Tanner stage (P < 0.05, P < 0.01, P < 0.01, P < 0.001, respectively). The direct correlation found in normal boys between inhibin B levels and LH, testosterone and testicular volume was not observed in patients with varicocele.

CONCLUSIONS: The altered serum profile of gonadal hormones observed in untreated prepubertal and pubertal patients with varicocele may indicate an early abnormal regulation of the seminiferous epithelium function.