Soudabeh Sabetian, Ali M Ardekani, Mahshid Hodjat, Mohammad Mehdi Akhondi, Haleh Soltanghoraee, Naser Amirjannati, Niknam Lakpour, Mohammad Reza Sadeghi
Department of Biology, Islamic Azad University, Science and Research Branch, Tehran, Iran.
J Reprod Infertil. 2010 Apr;11(1):39-46.
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.
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.
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.
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.
无精子症影响着超过10% - 15%前往不孕不育诊所就诊的男性不育患者。目前，睾丸活检是评估无精子症男性精子发生状态的金标准程序。精液采集和分析是一种非侵入性方法，已被证明在精子发生评估中具有重要价值。鉴定具有睾丸或睾丸外起源的精浆标志物对于预测睾丸组织中精子的存在以及无精子症的推测原因具有重要价值。本研究的目的是通过比较正常精子症和无精子症男性使用不同方法检测的精浆含量来寻找此类标志物。
从伊朗德黑兰的阿维森纳不孕不育诊所（AIC）就诊的200名男性中采集精液样本。根据世界卫生组织指南对精液样本进行分析。根据精液分析结果，将受试者分为两组：正常精子症组（n = 100；第一组）和无精子症组（n = 100；第二组）。通过高速离心分离精浆并储存在-20°C。检测精浆中的四种标志物，包括果糖、中性α-葡萄糖苷酶（NαG）、抑制素B和抗苗勒管激素（AMH）。果糖和NαG通过分光光度法评估，而抑制素B和AMH通过酶联免疫吸附测定法评估。通过睾丸活检后的组织病理学方法评估无精子症组的精子发生状态。
两组之间果糖浓度无差异。然而，它与精子计数显著相关（p < 0.01，r = -0.408）。与无精子症男性相比，正常精子症受试者的精浆抑制素B（OR：1.01；95%：CI：1.005 - 1.016）、AMH（OR：1.63；95% CI：1.17 - 2.28）和NαG（OR：1.07；95% CI：1.04 - 1.1）水平更高。根据睾丸活检中是否存在成熟精子，两组之间抑制素B和AMH浓度存在显著差异（p < 0.01）。在正常精子症组中，抑制素B浓度与精子计数呈正相关，然而，NαG浓度与正常精子症男性的精子计数（p < 0.01，r = 0.345）以及两组受试者的年龄相关。
抑制素B和AMH与睾丸组织样本中精子的存在相关。根据抑制素B和AMH浓度的非特异性变化，建议在精浆中鉴定更特异性的分子标志物以明确评估精子发生状态。
