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I N F E R T I L I T Y A F F E C T S A S m a n y a s 15 percent of couples trying to conceive, and in approximately half of these cases, the problem can be traced to ineffi cient sperm production or delivery, according to the Mayo Clinic. Male infertility is caused by one o f t w o f u n c t i o n a l d e f i c i e n c i e s . Obstructive infertility is marked by effectively produced sperm that isn't properly released due to ana- tomical blockages. Males who have nonobstructive infertility produce extremely low, if any, sperm. When blood and semen analyses, in concert with other tests, reveal low levels or the absence of sperm, phy sicia ns p er for m biops y — a method that involves inserting as many as three needles into the testi- cles — to differentiate obstructive from nonobstructive infertility. Definitive diagnosis is determined by the presence of sperm in the testicles — the cause is obstructive if sperm is found, nonobstruc- tive if not. Testicula r biopsy ca rries risks for bleeding and infection, and following t he procedure, men ca n experience soreness, as well as scrotal swelling and discoloration, according to the National Institutes of Health. No More Needles While tr ying to develop methods for determining the effi cacy of vasec- tomy, researchers from Mount Sinai Hospita l 's Lunenfeld-Ta nenbaum Research Institute in Toronto identi- fi ed two biomarkers — proteins in seminal fl uid — that could help diagnose infertility type. Epid idy m is- ex presse d ECM1 a nd test is- e x pre s s e d T E X 101 w ere u s e d t o t e s t 1 19 semina l plasma sa mples from a population made up of men with and without fertilit y problems. Resea rchers published results in t he November issue of t he journa l Science Translational Medicine. The researchers found they could differentiate obstructive infertility from normal spermatogen- esis (the process by which sperm is generated), as well as obstr uctive from nonobstr uctive infertility problems, using the two proteins and various assays. In their paper, the team states this discovery could improve diagnostics for male infertility: "Clinical assays for ECM1 and TEX101 have the potential to replace most of the diagnostic testicular biopsies and facilitate the prediction of outcome of sperm retrieval procedures, thus increasing the reliability and success of assisted reproduction techniques." The Way of the Future? Biomarkers represent a new wave of noninva- sive testing that could be as accurate as biopsy. Studies continue to evaluate the process, and researchers believe commercial tests could be available in the near future. ■ Less Painful Male Infertility Testing? By Michael Ferguson IN WHAT IS SURE TO BE WELCOME NEWS FOR MANY MEN, RESEARCHERS SAY THEY MIGHT HAVE DEVELOPED A DEFINITIVE DIAGNOSTIC TOOL THAT AVOIDS TESTICULAR BIOPSY. SEARCH AND RESCUE MALES WITH NONOBSTRUCTIVE infertility can produce small amounts of sperm that can be harvested for in vitro fertilization, but operations for retrieval can be long and arduous. Surgeons incise a testicle and use a microscope to locate sperm in a procedure that can take hours, but these operations aren't always successful. TEX101, a protein in seminal fl uid, has demon- strated effectiveness in identifying when absolutely no sperm is present, allowing patients to avoid unnecessary procedures and explore other options. CORE M D N E W S . CO M ■ MD NEWS San Antonio | 2 1