ANTI-MULLERIAN HORMONE AND INHIBIN B AS A DIAGNOSTIC REPLACEMENT OF HUMAN CHORIONIC GONADOTROPIN STIMULATION TEST IN EVALUATION OF 46 XY DISORDERS OF SEX DEVELOPMENT

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Fatma Ahmed Fathi Elmougy
Mona Hassan Hafez
Reham Assem AlEssawy
Soha Hamed Ammar Abd-Elhaleem
Hend M. Soliman
Rania Essam Ali Gamal Eldin

Keywords

46 XY DSD, inhibin B, anti-Mullerian hormone (AMH), testosterone

Abstract

Background: As blood anti-Müllerian hormone (AMH) measurement may assess male gonad function without the need of invasive dynamic testing, it is becoming more and more common. A measurement of inhibin B may be thought of as a diagnosis tool that provides accurate data regarding the existence and functionality of the tests.


Objective: To assess the role of AMH and inhibin-B in diagnosis of 46, XY disorders of sex development (DSD) in comparison to HCG stimulation test.


Patients and methods: 42 individuals with 46 XY DSD were the subject of the research, which also included 42 healthy male participants from DEMPU, New Pediatric Hospital, and Cairo University. The analyzed patients had a 4 year average age.


Results: there was a statistically considerable variation between level of AMH in testicular agenesis/dysgenesis and 46 XY DSD group (p˂0.001). Basal AMH and HCG-activated testosterone and DHT showed a substantial connection. Inhibin B, HCG-stimulated testosterone, and DHT were not shown to be substantially connected with one another. At a cut-off value of (43.2ng/ml), the sensitivity of AMH was (90.9%), specificity (96.8%), NPV (90.91%) PPV (96.77%), with overall accuracy (95.24%) to determine if functioning testicular tissue is present. While the inhibin B showed no discrimination between subjects who had functioning testicular tissue from those who had not.


Conclusion:  AMH is valuable reliable non-invasive parameter for identifying functional testicular tissue in 46 XY DSD patients.

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