Relationship of Azoospermia Factor (AZF) and Inhibin B Level in Patients with Non-Obstructive Azoospermia

Background: Non-obstructive azoospermia (NOA) is a challenging subset in management of infertile males. Micro-deletion of the azoospermia factor (AZF) region located on long arm of the Y-chromosome (Yq11) is considered as the commonest observed genetic cause among infertile males. Inhibin-B was identified to be a more sensitive factor in evaluating azoo-spermic males than FSH and testicular biopsies. Patients and Methods: In this prospective case-control study, 150 participants were separated into two groups: group (A) consisted of 75 patients with non-obstructive azoospermia, and group (B) consisted of 75 age-matched, fertile men having a child in the year prior to the study as a control group. Entire cases were subjected to full history taking and complete examination followed by laboratory analysis which comprised semen analysis, hormonal assays, including TSH, FSH, LH, E2, prolactin, total testosterone, and inhibin-B and detection of AZF micro-deletion. Results: PRL, FSH, and LH were significantly higher (P 0.028, < 0.001, < 0.001), while total testosterone, inhibin-B level, TT/FSH, and inhibin-B/FSH ratios were significantly lower (p< 0.001 for each) among azoospermia cases compared with control group. The frequency of AZF micro-deletions among azoospermia cases was 40/75 (53.3%). AZFc deletion was the most frequent type of Y-chromosome micro-deletion. Conclusion: AZF and inhibin B levels were demonstrated to be significantly correlated in patients with non-obstructive azoospermia. Higher FSH, lower testosterone, and lower inhibin-B levels could be considered as risk predictors for azoospermia, but could not be considered as risk predictor of AZF deletion among azoospermia cases.