Abstract

Hussain Kh. Kadhem, Hayder A. L. Mossa* and Ula M. Alkawaz

ABSTRACT

Background: The seminal plasma protein assessment of epidydmal specific protein 1 or extracellular matrix protein 1(ECM1) is already discovered and under final development for clinical use . Immunoassays of ECM1 has the potential to roll out most of the histopathological diagnosis of testicular biopsies and testicular sperm extraction (TESE) procedures for patients with azoospermia, and to reduce the total cost of azoospermia diagnosis. Aim of study: Evaluation clinical role of ECM1 in the diagnosis of obstructive azoospermia in relevance to its histological findings. Patients and Methods: The case control study conducted on 65 azoospermia male in the period from January 2018 to February 2019 at the High Institute for Infertility Diagnosis & Assisted Reproductive Technologies at Al-Nahrain University in Baghdad-IRAQ, all the 65 patients were undergone clinical examination and laboratory investigation such as hormonal, seminal fluid analysis is and seminal plasma collection and freezing to be thawed later for assessment seminal plasma proteins ECM1by ELISA technology as well as testicular biopsy with histopathological diagnosis. A blood sample was taken for all patients for assessment serum level of LH, FSH and testosterone. Written informed consent was obtained from all patients. Results: the mean age was recoding 33.37 ± 6.99 years. Histopathological findings were recording 10 (15.38%) cases of normal spermatogenesis obstructive azoospermia (OA) and 55(84.62%) cases of abnormal spermatogenesis or non-obstructive azoospermia(NOA) and Serum level of follicle stimulating hormone(FSH) and Luteinizing hormone(LH) were highly significantly lowest (P ? 0.01) in men with normal spermatogenesis. Seminal plasma level of ECM1 was significantly (P< 0.001) higher in men with abnormal spermatogenesis than men with normal spermatogenesis, 1629.10 (458.13) pg/ml versus 469.60 (737.29) pg/ml respectively. Receiver operating characteristic curve(ROC) analysis was carried out and the results are shown the ECM1cutoff value was > 943.11pg/ml with a sensitivity rate of 87.3% and specificity rate of 90%. In addition the accuracy rate was 87.1% and P < 0.001. Conclusion: Seminal plasma ECM1 protein can be used for diagnosis of obstructive azoospermia especially if combined with reproductive hormones.