Evaluation of Seminal IGF-1 and α2-macroglobulin Measurement in Predicting Testicular Sperm Output

Abstract

Oligozoospermia is a common presentation of male infertility. It is defined by having less than 15 million sperms/ml of the semen and is most commonly considered by most clinicians to be functional as a result of deficient spermatogenesis. Nevertheless, the existence of obstructive etiology “whether partial or unilateral” must be always put in mind. Testicular biopsy is most commonly examined by the clinicians in a descriptive, non-quantitative way. This has severely limited its usefulness and led to many errors in its interpretation. For that same reason, testicular biopsy has not found much use in men with oligozoospermia. Obstructive oligozoospermia is defined as the lack of a correlation between the number of mature spermatids (Sc + Sd) in the testicular biopsy and sperm concentration per milliliter in the ejaculate. Thus, to establish a definite diagnosis of partial obstruction, the patient may be subjected to the complications of the testicular biopsy. At the same time, failure to identify instances of partial obstruction may subject the patient to unnecessary treatments. Therefore, it seems important not to miss this possibility of partial obstruction in any case of unexplained oligozoospermia and at the same time to find an easy and non-invasive way for confirming this diagnostic possibility.