Relationships between FSH, inhibin B, anti-Mullerian hormone, and testosterone during long-term treatment with the GnRH-agonist histrelin in patients with prostate cancer

Abstract

Objectives: Medical castration with long-acting GnRH-agonist (GnRHa) is a well-established treatment for metastatic prostate cancer. Our aim was to explore the relationships between FSH, inhibin B, antiMullerian hormone (AMH), and testosterone during treatment with an implant releasing GnRHa. Design: Analysis of hormone levels in frozen serum samples. Methods: Ten patients aged 77G7 (meansGS.E.M.) years with prostate cancer were treated with the GnRHa histrelin for at least a year. Two weeks prior to insertion and for 3-4 months following removal the patients were treated with the antiandrogen flutamide. Serum inhibin B, FSH, testosterone, and AMH levels were measured retrospectively. Results: FSH, inhibin B, and testosterone increased during antiandrogen administration and levels fell after implant insertion. Four weeks post insertion, FSH gradually increased while inhibin B and testosterone remained fully suppressed. AMH levels did not change during antiandrogen treatment, but increased following implant insertion and remained elevated for the duration of implant use. Following removal, FSH and testosterone increased, inhibin B remained low, while AMH decreased. Conclusions: The secondary increase in FSH following initial suppression with the implant is probably related to impaired inhibin B secretion. The lack of inhibin B response to the secondary increase in FSH suggests that long-term exposure of Sertoli-cells to GnRHa impairs their function. This effect appears to be selective since unlike inhibin B, AMH increased. In the absence of testosterone, FSH has a role in AMH regulation.

Elderly Men Have Low Levels of Anti-Müllerian Hormone and Inhibin B, but with High Interpersonal Variation: A Cross-Sectional Study of the Sertoli Cell Hormones in 615 Community-Dwelling Men

“…A dysynchrony between LH and testosterone occurs in elderly men [29]. Consequently, alteration of the gonadal-pituitary axis may also be important for age-related changes in Sertoli cell hormones, as FSH regulates InhB [30] and as AMH is putatively under the control of GnRH [31]. LH and FSH exhibit a circhoral rhythm in men [32], whereas AMH has a half-life of greater than a day [33].…”

Relationships between Anti-mullerian Hormone, Testosterone, Luteinizing Hormone and Follicle Stimulating Hormone in Men on Testosterone Therapy

“…However, when a GnRH agonist implant was also administered for a year, FSH and testosterone initially fell (again with no change in AMH), but a late and prolonged rise in FSH (from one month onwards with FSH rising back towards baseline levels) with sustained suppression of testosterone, was accompanied by a rise in AMH. The authors concluded that FSH has a role in regulating AMH in the absence of testosterone action [29]. In our study, there was no secondary rise in FSH back towards baseline and this may reflect the different therapies used to achieve FSH suppression, being a GnRH agonist implant in Eldar-Geva's group and exogenous testosterone therapy in our subjects.…”

“…An informative study by Eldar-Geva et al [29] reports treating 10 men with antiandrogens with a subsequent rapid rise in serum testosterone and FSH (as expected) and AMH did not change during this phase of therapy. However, when a GnRH agonist implant was also administered for a year, FSH and testosterone initially fell (again with no change in AMH), but a late and prolonged rise in FSH (from one month onwards with FSH rising back towards baseline levels) with sustained suppression of testosterone, was accompanied by a rise in AMH.…”

“…It has been suggested that non-genomic or androgen receptor independent pathways for testosterone to suppress AMH may also exist and this seems increasingly likely given the mounting evidence that changing serum testosterone or IT-T testosterone levels in adult men does not affect AMH [29]. It also seems likely that persistently rising FSH levels may have a role in modulating AMH levels in the absence of testosterone, as described by Eldar-Geva [29].…”

INHIBIN B MENURUNKAN KONSENTRASI FOLLICLE STIMULATING HORMONE (FSH) PADA TIKUS PUTIH (Rattus norvegicus): UPAYA PENGEMBANGAN KONTRASEPSI HORMON PRIA BERBASIS PEPTIDA

“…Hasil penelitian lain pada manusia menunjukkan bahwa level serum inhibin B berkorelasi erat dengan level serum FSH dan konsentrasi testosteron (Raivio et al, 2000). Selain itu, serum inhibin B berkorelasi signifikan dengan konsentrasi spermatozoa dan berkorelasi negatif dengan konsentrasi FSH (Eldar-Geva et al, 2010).…”