Journal of Reproduction & Infertility

Journal of Reproduction & Infertility

Comparing Seminal Plasma Biomarkers between Normospermic and Azoospermic Men

Authors
1 Department of Biology, Islamic Azad University, Science and Research Branch, Tehran, Iran
2 Reproductive Biotechnology Research Center, Avicenna Research Institute, ACECR, Tehran, Iran
3 Monoclonal Antibody Research Center, Avicenna Research Institute (ACECR), Tehran, Iran
Abstract
Introduction: Azoospermia affects more than 10% - 15% of infertile male subjects attending infertilty clinics. At present, testicular biopsy is the golden standard procedure for evaluating spermatogenesis status in men with azoospermia . Semen collection and analysis is a non-invasive method and has proven to be valuable in the evaluation of spermatogenesis. Identification of seminal plasma markers with testicular or extra-testicular origins have a great value in predicting the prescence of sperm in testicular tissue and presumptive cause of azoospermia. The aim of this study was to find such markers by comparing the content of seminal plasma using different methods in normospermic and azoospermic men.Matherials and Methods: Semen samples were collected from 200 men attending Avicenna Infertility Clinic (AIC) in Tehran, Iran. Semen samples were analysed according to WHO guidlines. The subjects were divided into two groups: normospermic (n = 100; group one) and azoospermic men (n = 100; group two) according to semen analysis results. Seminal plasma was separated by high speed centrifuagation and stored in -20° C. Four markers including fructose, neutral alpha glucosidase (NαG), inhibin B and anti-Müllerian hormone (AMH) were measured in seminal plasma. Fructose and NαG were evaluated by spectrophotometry, while inhibin B and AMH were assessed by ELISA method. The spermatogenesis status in the azoospermic group was evaluated by histopathological method following testicular biopsy.Results: Fructose concentration showed no difference between the two groups. However, it was significantly correlated with sperm count (p < 0.01, r = -0.408). Seminal plasma inhibin B (OR: 1.01; 95%: CI: 1.005 - 1.016), AMH (OR: 1.63; 95% CI: 1.17 - 2.28) and NαG, (OR: 1.07; 95% CI: 1.04 - 1.1) levels were higher in normospermic subjects compared to azoospermic men. There were significant differences in inhibin B and AMH concentrations between the two groups based on the presence or absence of mature sperm in testicular biopsies (p < 0.01). Inhibin B concentration was positively correlated with sperm count in the normospermic group, however, NαG concentration correlated with sperm count of normospermic men (p < 0.01, r = 0.345) and the subjects’age in both groups.Conclusion: Inhibin B and AMH were correlated with the presence of sperm in testicular tissue samples. According to non-specific changes in inhibin B and AMH concentrations, identification of more specific molecular markers in seminal plasma to definitely evaluate the status of spermatogenesis is recommended.
Keywords

  1. Sharlip ID, Jarow JP, Belker AM, Lipshultz LI, Sigman M, Thomas AJ, et al. Best practice policies for male infertility. Fertil Steril. 2002;77(5):873-82.
  2. Thonneau P, Marchand S, Tallec A, Ferial ML, Ducot B, Lansac J, et al. Incidence and main causes of infertility in a resident population (1,850,000) of three French regions (1988-1989). Hum Reprod. 1991;6(6):811-6.
  3. Brugh VM 3rd, Lipshultz LI. Male factor infertility: evaluation and management. Med Clin North Am. 2004;88(2):367-85.
  4. Song GJ, Lee H, Park Y, Lee HJ, Lee YS, Seo JT, et al. Expression pattern of germ cell-specific genes in the testis of patients with nonobstructive azoosperm-ia: usefulness as a molecular marker to predict the presence of testicular sperm. Fertil Steril. 2000;73 (6):1104-8.
  5. Jarow JP, Espeland MA, Lipshultz LI. Evaluation of the azoospermic patient. J Urol. 1989;142(1):62-5.
  6. Anguiano A, Oates RD, Amos JA, Dean M, Gerrard B, Stewart C, et al. Congenital bilateral absence of the vas deferens. A primarily genital form of cystic fibrosis. JAMA. 1992;267(13):1794-7.
  7. Sobek A, Hrbková K, Mucha Z, Vodicka J, Tesarová M, Zát'ura F, et al. Infertility treatment of men with non-obstructive azoospermia. Acta Univ Palacki Olomuc Fac Med. 1998;141:83-5.
  8. Mercan R, Urman B, Alatas C, Aksoy S, Nuhoglu A, Moldenhauer JS, et al. Outcome of testicular sperm retrieval procedures in non-obstructive azoo-spermia: percutaneous aspiration versus open bi-opsy. Hum Reprod. 2000;15(7):1548-51.
  9. Moldenhauer JS, Ostermeier GC, Johnson A, Dia-mond MP, Krawetz SA. Diagnosing male factor infertility using microarrays. J Androl. 2003;24(6): 783-9.
  10. Kumanov P, Nandipati KC, Tomova A, Robeva R, Agarwal A. Significance of inhibin in reproductive pathophysiology and current clinical applications. Reprod Biomed Online. 2005;10(6):786-812.
  11. Jenkins AD, Turner TT, Howards SS. Physiology of the male reproductive system. Urol Clin North Am. 1978;5(3):437-50.
  12. Andersson AM. Inhibin B in the assessment of seminiferous tubular function. Baillieres Best Pract Res Clin Endocrinol Metab. 2000;14(3):389-97.
  13. Blumenfeld Z, Ritter M. Inhibin, activin, and follistatin in human fetal pituitary and gonadal physiology. Ann N Y Acad Sci. 2001;943:34-48.
  14. Fujisawa M, Yamasaki T, Okada H, Kamidono S. The significance of anti-Müllerian hormone con-centration in seminal plasma for spermatogenesis. Hum Reprod. 2002;17(4):968-70.
  15. Rey R. Assessment of seminiferous tubule function (anti-müllerian hormone). Baillieres Best Pract Res Clin Endocrinol Metab. 2000;14(3):399-408.
  16. Mahmoud AM, Geslevich J, Kint J, Depuydt C, Huysse L, Zalata A, et al. Seminal plasma alpha-glucosidase activity and male infertility. Hum Reprod. 1998;13(3):591-5.
  17. Zöpfgen A, Priem F, Sudhoff F, Jung K, Lenk S, Loening SA, et al. Relationship between semen quality and the seminal plasma components carni-tine, alpha-glucosidase, fructose, citrate and granu-locyte elastase in infertile men compared with a normal population. Hum Reprod. 2000;15(4):840-5.
  18. Aumüller G, Riva A. Morphology and functions of the human seminal vesicle. Andrologia. 1992;24 (4):183-96.
  19. Tournaye H, Verheyen G, Nagy P, Ubaldi F, Goossens A, Silber S, et al. Are there any predict-ive factors for successful testicular sperm recovery in azoospermic patients? Hum Reprod. 1997;12(1): 80-6.
  20. Ezeh UI, Taub NA, Moore HD, Cooke ID. Establishment of predictive variables associated with testicular sperm retrieval in men with non-obstructive azoospermia. Hum Reprod. 1999;14(4): 1005-12.
  21. El Garem YF, El Arini AF, El Beheiry AH, Zeid SA, Comhaire FH. Possible relationship between seminal plasma inhibin B and spermatogenesis in patients with azoospermia. J Androl. 2002;23(6): 825-9.
  22. Paquin R, Chapdelaine P, Dubé JY, Tremblay RR. Similar biochemical properties of human seminal plasma and epididymal alpha-1,4-glucosidase. J Androl. 1984;5(4):277-82.
  23. Henkel R, Maass G, Schuppe HC, Jung A, Schubert J, Schill WB. Seasonal changes of neutral alpha-glucosidase activity in human semen. J Androl. 2006;27(1):34-9.
  24. Sandoval L, Diaz M, Rivas F. Alpha-1,4-gluco-sidase activity and the presence of germinal epithelium cells in the semen for differential diagnosis of obstructive and nonobstructive azoo-spermia. Arch Androl. 1995;35(2):155-8.
  25. Duan L, Er X, Zhao J, Duan L, Liu Q, Liu R, et al. [Analysis of the relative etiology of non-obstruct-ive azoospermia]. Zhonghua Nan Ke Xue. 2004;10 (8):616-8, 622. Chinese.
  26. Gonzales GF, Garcia-Hjarles MA, Gutierrez R, Guerra-Garcia R. The secretory activity of the seminal vesicles and its relationship to sperm motility: effects of infection in the male reproduct-ive tract. Int J Androl. 1989;12(4):286-94.
  27. Mann T. Fructose, polyols, and organic acids. In: Nam T, editor. The Biochemistry of Semen and of the Male Reproductive Tract. London: Methuen & Co. Ltd; 1964. p. 273-44.
  28. Buckett WM, Lewis-Jones DI. Fructose concentra-tions in seminal plasma from men with non-obstructive azoospermia. Arch Androl. 2002;48(1): 23-7.
  29. Duvilla E, Lejeune H, Trombert-Paviot B, Gentil-Perret A, Tostain J, Levy R. Significance of inhibin B and anti-Müllerian hormone in seminal plasma: a preliminary study. Fertil Steril. 2008;89(2):444-8.
  30. Fénichel P, Rey R, Poggioli S, Donzeau M, Chevallier D, Pointis G. Anti-Müllerian hormone as a seminal marker for spermatogenesis in non-obstructive azoospermia. Hum Reprod. 1999;14(8): 2020-4.
  31. Baarends WM, Hoogerbrugge JW, Post M, Visser JA, De Rooij DG, Parvinen M, et al. Anti-müllerian hormone and anti-müllerian hormone type II receptor messenger ribonucleic acid expres-sion during postnatal testis development and in the adult testis of the rat. Endocrinology. 1995;136 (12):5614-22.
  32. Aydos K, Demirel LC, Baltaci V, Unlü C. Enzymatic digestion plus mechanical searching improves testicular sperm retrieval in non-obstruct-ive azoospermia cases. Eur J Obstet Gynecol Reprod Biol. 2005;120(1):80-6.
  33. Tsujimura A, Matsumiya K, Miyagawa Y, Takao T, Fujita K, Koga M, et al. Prediction of successful outcome of microdissection testicular sperm ex-traction in men with idiopathic nonobstructive azoospermia. J Urol. 2004;172(5 Pt 1):1944-7.
  34. Mostafa T, Amer MK, Abdel-Malak G, Nsser TA, Zohdy W, Ashour S, et al. Seminal plasma anti-Müllerian hormone level correlates with semen parameters but does not predict success of testicu-lar sperm extraction (TESE). Asian J Androl. 2007; 9(2):265-70.
  35. Tunc L, Kirac M, Gurocak S, Yucel A, Kupeli B, Alkibay T, et al. Can serum Inhibin B and FSH levels, testicular histology and volume predict the outcome of testicular sperm extraction in patients with non-obstructive azoospermia? Int Urol Nephrol. 2006;38(3-4):629-35.
  36. Ballescá JL, Balasch J, Calafell JM, Alvarez R, Fábregues F, de Osaba MJ, et al. Serum inhibin B determination is predictive of successful testicular sperm extraction in men with non-obstructive azoospermia. Hum Reprod. 2000;15(8):1734-8.
  37. Anderson RA, Irvine DS, Balfour C, Groome NP, Riley SC. Inhibin B in seminal plasma: testicular origin and relationship to spermatogenesis. Hum Reprod. 1998;13(4):920-6.
  38. Young J, Couzinet B, Chanson P, Brailly S, Loumaye E, Schaison G. Effects of human recombinant luteinizing hormone and follicle-stimulating hormone in patients with acquired hypogonadotropic hypogonadism: study of Sertoli and Leydig cell secretions and interactions. J Clin Endocrinol Metab. 2000;85(9):3239-44.
  39. Anderson RA. Clinical studies: inhibin in the adult male. Mol Cell Endocrinol. 2001;180(1-2):109-16.