Less Painful Male Infertility Testing?

By: Michael Ferguson
Tuesday, June 24, 2014
Specialty: 

In what is sure to be welcome news for many men, researchers say they might have developed a definitive diagnostic tool that avoids testicular biopsy.

Infertility affects as many as 15 percent of couples trying to conceive, and in approximately half of these cases, the problem can be traced to inefficient sperm production or delivery, according to the Mayo Clinic.

Male infertility is caused by one of two functional deficiencies. Obstructive infertility is marked by effectively produced sperm that isn’t properly released due to anatomical blockages. Males who have nonobstructive infertility produce extremely low, if any, sperm.

When blood and semen analyses, in concert with other tests, reveal low levels or the absence of sperm, physicians perform biopsy — a method that involves inserting as many as three needles into the testicles — to differentiate obstructive from nonobstructive infertility. Definitive diagnosis is determined by the presence of sperm in the testicles — the cause is obstructive if sperm is found, nonobstructive if not.

Testicular biopsy carries risks for bleeding and infection, and following the procedure, men can experience soreness, as well as scrotal swelling and discoloration, according to the National Institutes of Health.

No More Needles

While trying to develop methods for determining the efficacy of vasectomy, researchers from Mount Sinai Hospital’s Lunenfeld-Tanenbaum Research Institute in Toronto identified two biomarkers — proteins in seminal fluid — that could help diagnose infertility type.

Epididymis-expressed ECM1 and testis-expressed TEX101 were used to test 119 seminal plasma samples from a population made up of men with and without fertility problems. Researchers published results in the November issue of the journal Science Translational Medicine.

The researchers found they could differentiate obstructive infertility from normal spermatogenesis (the process by which sperm is generated), as well as obstructive from nonobstructive infertility problems, using the two proteins and various assays. In their paper, the team states this discovery could improve diagnostics for male infertility: “Clinical assays for ECM1 and TEX101 have the potential to replace most of the diagnostic testicular biopsies and facilitate the prediction of outcome of sperm retrieval procedures, thus increasing the reliability and success of assisted reproduction techniques.”

The Way of the Future?

Biomarkers represent a new wave of noninvasive testing that could be as accurate as biopsy. Studies continue to evaluate the process, and researchers believe commercial tests could be available in the near future.