Seminal angiotensin II as a predictive factor of spermatogenic activity in non-obstructive azoospermia

There is an unmet need for a non-invasive marker to predict spermatogenic potential and the likelihood of finding mature sperm in cases of non-obstructive azoospermia (NOA). Accordingly, we assessed the level of seminal angiotensin II (Ang II), which is suggested to be linked to sperm motility and count, and its relation to spermatogenic activity.

A prospective case-control study included three groups: Group I, consisting of 30 male patients with NOA; Group II, consisting of 30 male patients with obstructive azoospermia (OA); and Group III, consisting of 30 healthy fertile males as the control group.

Seminal Ang II levels were significantly lower in OA patients compared to NOA patients (p < 0.001) and controls (p < 0.001). Additionally, angiotensin II levels were significantly lower among NOA patients than controls (p < 0.001). In NOA patients, the lowest Ang II average was observed in those with Sertoli cell-only syndrome (SCO) and the highest in those with late maturation arrest (p ≤ 0.05).

Our findings suggested that seminal Ang II may serve as a predictive marker for spermatogenesis and the presence of mature sperm in microsurgical testicular sperm extraction (micro-TESE) in cases of non-obstructive azoospermia.