Evaluation of the Utility of Seminal Plasma Resistin and Leptin in  Predicting Successful Surgical Sperm Retrieval in Men with Non-Obstructive Azoospermia

Medhat  Kamel Amer; Wael  Zohdy; Sameh Fayek  GamalEl Din; Hanan  Hosni Moawad; Dina Atef  Hasan El Saedy; Eman Ahmed  Zaki Gamal; Ahmed  Ragab

doi:10.18502/jri.v24i2.12496

Medhat Kamel Amer Department of Andrology, Sexology and STDs, Faculty of Medicine, Cairo University, Cairo, Egypt
Wael Zohdy Department of Andrology, Sexology and STDs, Faculty of Medicine, Cairo University, Cairo, Egypt
Sameh Fayek GamalEl Din Department of Andrology, Sexology and STDs, Faculty of Medicine, Cairo University, Cairo, Egypt
Hanan Hosni Moawad Department of Clinical and Chemical Pathology, Faculty of Medicine, Beni-Suef University, Beni Suef, Egypt
Dina Atef Hasan El Saedy Egypt Ministry of Health and Population, Cairo, Egypt
Eman Ahmed Zaki Gamal Egypt Ministry of Health and Population, Cairo, Egypt
Ahmed Ragab Department of Andrology, Sexology and STDs, Faculty of Medicine, Beni-Suef University, Beni Suef, Egypt

DOI: https://doi.org/10.18502/jri.v24i2.12496

Keywords: Leptin, Male infertility, Non-obstructive azoospermia, Resistin, Seminal plasma.

Abstract

Background: The purpose of the current study was evaluation of the utility of seminal plasma (SP) resistin and leptin in predicting successful surgical sperm retrieval (SSR) in men with non-obstructive azoospermia (NOA).

Methods: This prospective comparative study was conducted in the andrology clinic of a specialized fertility center. In total, 53 NOA men as candidates for either first time micro‐testicular sperm extraction (micro-TESE) or repeat micro-TESE and 28 normozoospermic controls were included. ELISA was used for measurement of SP resistin and leptin levels in all participants. Significance level was defined as p< 0.05.

Results: The current study demonstrated a significant positive correlation between estradiol (E2) level in serum and SP resistin (r=0.342, p=0.025). Also, there was a highly significant positive correlation between SP leptin and SP resistin (r=0.568, p= 0.001). Interestingly, SP leptin was the only variable that demonstrated a significant correlation with eventful micro-TESE outcome in men who underwent micro-TESE for the first time. Finally, ROC curve showed that SP leptin level of 4.05 ng/ml predicted successful SSR in men who underwent micro-TESE for the first time with a sensitivity of 73.3% and a specificity of 75% as 11 out of 27 (41%) cases showed eventful micro-TESE at or above this cut-off level [AUC of 0.747, 95% CI, lower bound of 0.555, and upper bound of 0.939, p=0.030].

Conclusion: SP leptin can be used as a non-invasive biomarker to predict successful SSR in NOA cases undergoing first time micro-TESE, while SP resistin failed to play the same role.