OBJECTIVE: To evaluate heat shock factor Y chromosome (HSFY) mRNA as a biomarker for the presence of retrievable testicular sperm. DESIGN: Case-control study. SETTING: Academic medical center. PATIENT(S): Men with nonobstructive azoospermia (NOA). INTERVENTION(S): Testicular tissue from men with successful or failed testicular sperm extraction was evaluated with qunatitative real-time polymerase chain reaction (qRT-PCR) for expression of HSFY mRNA. MAIN OUTCOME MEASURE(S): Area under the receiver operating characteristic curve (AUC), sensitivity, specificity, and probability of sperm retrieval based on HSFY testing. RESULT(S): We found higher HSFY mRNA expression in testicular tissue from NOA patients in whom sperm were successfully retrieved compared with those in whom sperm were not found, with good discrimination between the groups in all histologic variants of NOA (AUC 0.89 overall, 0.98 for patients with Sertoli cell only [SCO] histology, 0.90 for patients with maturation arrest [MA] histology). Sensitivity and specificity were, respectively, 67% and 93% overall, 92% and 100% for SCO patients, and 67% and 92% for MA patients. The probabilities of sperm retrieval for HSFY-positive and -negative patients were, respectively, 93% and 31% overall, 100% and 7% for SCO patients, and 91% and 32% for MA patients. CONCLUSION(S): Detection of HSFY mRNA expression by qRT-PCR has promising application in the evaluation and counseling of men with NOA before attempted sperm retrieval surgery.
OBJECTIVE: To evaluate heat shock factor Y chromosome (HSFY) mRNA as a biomarker for the presence of retrievable testicular sperm. DESIGN: Case-control study. SETTING: Academic medical center. PATIENT(S): Men with nonobstructive azoospermia (NOA). INTERVENTION(S): Testicular tissue from men with successful or failed testicular sperm extraction was evaluated with qunatitative real-time polymerase chain reaction (qRT-PCR) for expression of HSFY mRNA. MAIN OUTCOME MEASURE(S): Area under the receiver operating characteristic curve (AUC), sensitivity, specificity, and probability of sperm retrieval based on HSFY testing. RESULT(S): We found higher HSFY mRNA expression in testicular tissue from NOA patients in whom sperm were successfully retrieved compared with those in whom sperm were not found, with good discrimination between the groups in all histologic variants of NOA (AUC 0.89 overall, 0.98 for patients with Sertoli cell only [SCO] histology, 0.90 for patients with maturation arrest [MA] histology). Sensitivity and specificity were, respectively, 67% and 93% overall, 92% and 100% for SCO patients, and 67% and 92% for MA patients. The probabilities of sperm retrieval for HSFY-positive and -negative patients were, respectively, 93% and 31% overall, 100% and 7% for SCO patients, and 91% and 32% for MA patients. CONCLUSION(S): Detection of HSFY mRNA expression by qRT-PCR has promising application in the evaluation and counseling of men with NOA before attempted sperm retrieval surgery.