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Review
. 2023 Apr 20;33(1):9.
doi: 10.1186/s12610-023-00184-0.

Seminal plasma biomarkers for predicting successful sperm retrieval in patients with nonobstructive azoospermia: a narrative review of human studies

Junjun Li  1 , Fang Yang  2 , Liang Dong  3 , Degui Chang  2 , Xujun Yu  4
Affiliations
Review

Seminal plasma biomarkers for predicting successful sperm retrieval in patients with nonobstructive azoospermia: a narrative review of human studies

Junjun Li et al. Basic Clin Androl. .

Abstract
in English, French

Background: Non-obstructive azoospermia (NOA) is considered to be the most severe form of male infertility. Before the emergence of surgical testicular sperm extraction and assisted reproductive technology, NOA patients could hardly become biological fathers of their children. However, failure of the surgery could cause physical and psychological harm to patients such as testicular damage, pain, hopeless of fertility and additional cost. Therefore, predicting the successful sperm retrieval (SSR) is so important for NOA patients to make their choice whether to do the surgery or not. Because seminal plasma is secreted by the testes and accessory gonads, it can reflect the spermatogenic environment, making it a preferential choice for SSR valuation. The purpose of this paper is to summarize the available evidence and provide the reader with a broad overview of biomarkers in seminal plasma for SSR prediction.

Results: A total of 15,390 studies were searched from PUBMED, EMBASE, CENTRAL and Web of Science, but only 6615 studies were evaluated after duplications were removed. The abstracts of 6513 articles were excluded because they were irrelevant to the topic. The full texts of 102 articles were obtained, with 21 of them being included in this review. The included studies range in quality from medium to high. In the included articles, surgical sperm extraction methods included conventional testicular sperm extraction (TESE) and microdissection testicular sperm extraction (micro-TESE). Currently, the biomarkers in seminal plasma used to predict SSR are primarily RNAs, metabolites, AMH, inhibin B, leptin, survivin, clusterin, LGALS3BP, ESX1, TEX101, TNP1, DAZ, PRM1 and PRM2.

Conclusion: The evidence does not conclusively indicate that AMH and INHB in seminal plasma are valuable to predict the SSR. It is worth noting that RNAs, metabolites and other biomarkers in seminal plasma have shown great potential in predicting SSR. However, existing evidence is insufficient to provide clinicians with adequate decision support, and more prospective, large sample size, and multicenter trials are urgently needed.

RéSUMé: CONTEXTE: L’azoospermie non obstructive (ANO) est considérée comme la forme la plus grave d’infertilité masculine. Avant l’émergence de l’extraction chirurgicale de spermatozoïdes testiculaires et de la procréation médicalement assistée, les patients atteints d’ANO pouvaient difficilement devenir les pères biologiques de leurs enfants. Cependant, l’échec de la chirurgie peut causer des dommages physiques et psychologiques aux patients, tels que des lésions testiculaires, des douleurs, une fertilité impossibilité et des coûts financiers supplémentaires. Par conséquent, prédire une récupération réussie de spermatozoïdes (RRS) est très important pour les patients avec ANO, pour faire leur choix de réaliser ou non la chirurgie. Comme le plasma séminal est sécrété par les testicules et les glandes accessoires, il peut être le reflet de l’environnement de la spermatogenèse, ce qui en fait un choix préférentiel pour l’évaluation de la RRS. Le but du présent article est de résumer les preuves disponibles, et de fournir au lecteur un aperçu général des biomarqueurs du plasma séminal susceptibles de prédire la RRS. RéSULTATS: Au total, 15390 études ont été consultées à partir de PUBMED, EMBASE, CENTRAL et Web of Science, mais seulement 6615 ont été évaluées après suppression des doublons. Les résumés de 6513 articles ont été exclus car non pertinents pour le sujet. Les textes intégraux de 102 articles ont été obtenus, dont 21 ont été inclus dans cette revue. La qualité des études incluses varie de moyenne à élevée. Dans ces articles inclus, la méthode chirurgicale d’extraction de spermatozoïdes était soit l’extraction conventionnelle de spermatozoïdes testiculaires (TESE), soit l’extraction de spermatozoïdes testiculaires par microdissection (micro-TESE). Actuellement, les biomarqueurs du plasma séminal utilisés pour prédire la RRS sont principalement les ARN, les métabolites, l’AMH, l’inhibine B, la leptine, la survivine, la clusterine, LGALS3BP, ESX1, TEX101, TNP1, DAZ, PRM1 et PRM2. CONCLUSIONS: Les preuves n’indiquent pas de façon concluante que l’AMH et l’INHB dans le plasma séminal sont utiles pour prédire la RRS. Il convient de noter que les ARN, métabolites et autres biomarqueurs du plasma séminal ont montré un potentiel élevé de prédiction de la RRS. Cependant, les preuves existantes sont insuffisantes pour fournir aux cliniciens une aide à la décision adéquate ; des essais plus prospectifs, de grande taille, et multicentriques sont nécessaires de toute urgence.

Keywords: Male infertily; Non-obstructive azoospermia; Seminal plasma; Successful sperm retrieval; Surgical testicular sperm extraction.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flowchart of study selection process. A total of 15,390 studies were searched, but only 6615 studies were evaluated after duplications were removed. The abstracts of 6513 articles were excluded because they were irrelevant to the topic. The full texts of 102 articles were obtained, with 21 of them being included in this review
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