Seminal clusterin level as a predictor for spermatogenesis before testicular sperm extraction

Background: A number of factors have been proposed to be of predictive benefit for males with a good probability to retrievesperms; as testicular volume, serum FSH, total testosterone and Inhibin B levels. However, a little information has beenpresent regarding the use of seminal Clusterin (CLU) for that purpose.Aim: We designed the study in order to estimate seminal CLU level for non-obstructive azoospermia (NOA) males undergoingTesticular sperm extraction (TESE), also to detect the possibility of its use as a predictor for spermatogenesis in those patients.Further, we aimed to analyze its relation to testicular size, semen volume, presence or absence of varicocele, hormonal profileand result of MD-TESE.Patients and Methods: A cross-sectional hospital-based study on a total of 176 males (of them; 88 with NOA and 88 normalfertile). A semen sample was obtained from each patient before micro-dissection (MD)-TESE surgery and from normal fertilemales. Seminal CLU was measured in all samples by Enzyme linked immunosorbent assay (ELISA).Results: Seminal CLU level significantly differ between NOA patients and normal fertile males (P-value = 0.000*). Asignificant positive relation was obtained between seminal CLU level with both semen volume and testicular size (P-value< 0.05). A non-significant correlation was obtained between seminal CLU level and result of micro-TESE (P-value > 0.05).Conclusion: CLU concentration in se minal plasma, which is proportional to the expression level of CLU in the testis differsignificantly between normal fertile males and NOA patients. Seminal CLU level not significantly associated with whether ornot spermatozoa can be successfully retrieved by MD-TESE. Thus, Seminal CLU level couldn't be used as a useful biomarkerfor the assessment of spermatogenic status in NOA patients before MD-TESE