Correlation between leptin content and sperm retrieval in cases of functional azoospermia

Introduction: Testicular sperm extraction (TESE) and intracytoplasmic sperm injection (ICSI) became the preferable techniques for solving the problem of azoospermic men. Non-invasive techniques are needed to predict sperm retrieval chance before TESE to avoid the psychological and physiological problems that may be developed. Aim: To investigate the correlation between serum, seminal and testicular leptin levels and sperm retrieval in functional azoospermic men. Methods: The study included 61 men classified into 4 groups; normozoospermia (NOR), obstructive azoospermia (OA), positive non-obstructive azoospermia (NOA (+)) and negative non-obstructive azoospermia (NOA (−)). Blood FSH, LH, Prolactin, Free and Total testosterone levels plus serum and seminal leptin levels were measured for all groups. For azoospermic groups, TESE and testicular leptin level were applied. Main outcome measures: Both OA and NOR groups were used as control groups. The prediction accuracy for FSH and serum, seminal and testicular leptin was compared by receiver operating characteristic (ROC) curve analysis. Results: There were no significant differences in serum leptin levels among the four groups. Azoospermic groups showed higher seminal leptin levels than the NOR group. Seminal and Testicular leptin levels of NOA (−) men were significantly increased in comparison with OA and NOA (+) men. There was a significant negative correlation between serum leptin and total testosterone concentrations, and a significant positive correlation between testicular and seminal leptin concentrations. In ROC curve; for differentiation between positive and negative NOA, areas under the curve (AUC) of testicular and seminal leptin were greater than that of serum leptin. The combination of seminal leptin with FSH gave AUC greater than that of FSH alone. Conclusion: There is a role for leptin in spermatogenesis, and seminal leptin can be used as a good assistant marker to increase the prediction accuracy for sperm retrieval in NOA men especially in combination with FSH