Non-invasive molecular biomarkers for predicting outcomes of micro-TESE in patients with idiopathic non-obstructive azoospermia

Abstract

Non-obstructive azoospermia (NOA), the most severe type of male infertility, affects approximately 1% of men worldwide. However, the aetiology of most NOA cases is not definite, that is defined as idiopathic NOA (INOA), posing a clinical conundrum worldwide. Most of these patients must receive donor sperm treatment until the emergence of microdissection testicular sperm extraction (micro-TESE). Although this procedure has recently become a promising treatment for INOA, the low sperm retrieval rate and testicular trauma have prompted us to explore appropriate non-invasive molecular biomarkers to predict the outcomes of sperm recovery preoperatively. Previous studies have identified a spectrum of biomarkers to address this challenging issue at various levels in different tissues, such as DNAs, RNAs, protein and steroid levels in the blood and seminal fluid. To better understand and assess the predictive values of diverse molecular biomarkers from different tissues on the outcome of sperm retrieval by micro-TESE in patients with INOA, we summarised recent findings and discussed the potential applications of these methods. The ultimate goal of this study was to provide references for further studies and clinical management.

Non-invasive biomarkers for sperm retrieval in non-obstructive patients: a comprehensive review

“…Recently, there has been growing interest in non-invasive biomarkers to predict sperm presence in NOA patients’ testes ( 10 ). These approaches are promising as they offer safer, less invasive alternatives to identify patients more likely to benefit from successful sperm retrieval, thus optimizing ART procedures and potentially reducing unnecessary surgeries.…”

Effectiveness of, and Satisfaction with, a Microsurgical Testicular Sperm Extraction Knowledge and Skills Masterclass for a World-Wide Audience

“…Non-obstructive azoospermia (NOA), affecting approximately 1% of men worldwide, is the most severe type of male infertility [ 1 ]. Although spermatozoa can be retrieved blindly using conventional testicular sperm extraction (TESE), it is only successful in a subset of these NOA patients [ 2 ].…”

“…A recent systematic review and meta-analysis as well as a range of studies found that age, testicular volume, follicle-stimulating hormone, luteinizing hormone, and testicular histopathology were valuable predictors of salvage mTESE extraction in NOA [ 12 13 ]. Furthermore, others proposed molecular biomarkers and noncoding RNAs in seminal plasma as predictors of sperm recovery [ 1 14 ]. Likewise, the characteristics of seminiferous tubules have been reported to predict mTESE outcomes among naive NOA patients [ 15 ].…”

Constructing a seventeen-gene signature model for non-obstructive azoospermia based on integrated transcriptome analyses and WGCNA

“…NOA, a disorder in which spermatozoa is absent in the ejaculate, is the most severe type of male infertility [8,9]. In the past, most NOA patients have received donor sperm treatment to achieve pregnancy via assisted reproductive techniques [10]. In 1994, a novel approach, namely, testicular sperm extraction (TESE), which retrieved sperm from the testes of NOA patients, made it possible for these patients to have their own offspring [8].…”