CDY1 and BOULE transcripts assessed in the same biopsy as predictive markers for successful testicular sperm retrieval

Objective: To evaluate the molecular markers CDY1 and BOULE in the same testicular biopsy for predicting success of sperm retrieval in azoospermic men. Design: Prospective study. Setting: University-affiliated medical center. Patient(s): Azoospermic men (n = 92) who underwent testicular sperm extraction (TESE) and who were classified as normal spermatogenesis, mixed atrophy, spermatocyte maturation arrest, or Sertoli cell only according to their combined histological and cytological testicular findings. Intervention(s): Quantitative and qualitative evaluation of testicular biopsies by histological and qualitative reverse transcriptase-polymerase chain reaction (RT-PCR) expression methodologies. Main Outcome Measure(s): CDY1 and BOULE expression and the presence of sperm cells in testicular tissue. Result(s): Both transcripts significantly predicted the presence of sperm cells by qualitative and quantitative methodologies. Although CDY1 had the best sensitivity by qualitative RT-PCR (98.3%), assessing both transcripts simultaneously had an additive efficacy compared with assessing CDY1 alone, improving the specificity from 84.4% to 96.3%. Conclusion(s): Assessing the expression of both CDY1 and BOULE by qualitative RT-PCR is a sensitive and feasible test for predicting the presence of sperm cells in testicular tissue and may serve as a predictive tool if repeated TESE is required. (Fertil Steril (R) 2011; 95: 2297-302. (C) 2011 by American Society for Reproductive Medicine.)