Inhibin B

Inhibin B is the βB-containing heterodimer of the inhibin α subunit (INHA) and activin βB subunit (INHBB), secreted chiefly by small antral follicle granulosa cells in the ovary and, in males, by Sertoli cells of the testis. Like inhibin A, it antagonizes activin signaling by binding ACVR2A/2B complexed with betaglycan, suppressing SMAD2/3 activation and thereby inhibiting pituitary FSH synthesis and secretion. Inhibin B is the physiologically dominant inhibin in males, where it serves as the principal circulating marker of Sertoli cell number and function, seminiferous tubule integrity and spermatogenesis: it declines with testicular damage, mumps orchitis, chemotherapy and aging, and is low in Klinefelter syndrome and after prepubertal gonadotoxic therapy. In women, inhibin B reflects the ovarian follicle reserve, rises during the follicular phase, and serves as a key marker of diminished ovarian reserve, premature ovarian insufficiency and polycystic ovary syndrome, as well as an outcome predictor in assisted reproduction.