Testicular sperm extraction prediction for patients with nonobstructive azoospermia by Raman spectroscopy

Area of Science:

• Biomedical Engineering
• Spectroscopy
• Andrology

Background:

• Non-obstructive azoospermia (NOA) presents a challenge for sperm retrieval.
• Predicting testicular sperm extraction (TESE) success is crucial for patient management.
• Current methods lack non-invasive predictive capabilities.

Purpose of the Study:

• To develop and validate a non-invasive method for predicting TESE success in men with NOA.
• To investigate the utility of Raman spectroscopy enhanced by HC-MOF for this purpose.
• To analyze seminal plasma biochemical profiles associated with TESE outcomes.

Main Methods:

• Retrospective case-control study involving 20 men with NOA undergoing microdissection TESE (microTESE).
• Analysis of seminal plasma using Raman spectroscopy (2800-3050 cm^-1) enhanced by hollow core microstructured optical fiber (HC-MOF).
• Comparison of spectral features, nuclear magnetic resonance (NMR) data, and reactive oxygen species (ROS) levels between successful (TESE(+)) and unsuccessful (TESE(-)) sperm retrieval groups.

Main Results:

• HC-MOF enhanced Raman spectroscopy identified distinct spectral differences in seminal plasma between TESE(+) and TESE(-) groups, linked to C-H stretching vibrations and potentially lipids.
• A diagnostic model utilizing principal component analysis (PCA) achieved 79% accuracy and 0.863 ROC AUC on the training set.
• Reactive oxygen species (ROS) levels did not show statistically significant predictive value (p > 0.05).

Conclusions:

• HC-MOF enhanced Raman spectroscopy is a rapid, non-invasive, and cost-efficient method for predicting TESE success in men with NOA.
• This technique reveals biochemical differences in seminal plasma, offering a potential pre-surgical screening tool.
• Further validation on larger cohorts is necessary, but this study shows promise for widespread clinical application to avoid unnecessary invasive procedures.