Abstract
Abstract Introduction LIM15, also known as DNA meiotic recombinase 1 (DMC1), is a meiosis-specific recombinase. LIM15 is specifically expressed as a meiotic recombination protein in spermatogenesis. Objective Does the LIM15 gene expression value measured in the ejaculate predict the success of the second micro–testicular sperm extraction (mTESE) after the failed first mTESE? Methods Data from 111 men who failed the first mTESE and underwent the second mTESE between August 2018 and March 2022 were prospectively collected. LIM15 gene expression level was determined by real-time PCR in the materials from the ejaculate. Results Sperm was recovered successfully in 23 out of 111 (20.7%) men with second mTESE. The mean age of men for whom sperm could not be retrieved and men with successful sperm recovery were 34.6 ± 3.5 and 33.7 ± 5.2, respectively. The mean patient age, serum total testosterone and FSH levels, and testicular volume did not show any statistical difference between men with successful sperm recovery and men with failed sperm recovery (Table 1). According to the testicular histology, the sertoli cell-only, maturation arrest, and hypospermatogenesis in men with successful sperm recovery were 26.1%, 65.2%, and 8.7%, and in men for whom sperm could not be retrieved were 0%, 27.3%, and 72.7%. Comparing the groups in terms of testicular histology demonstrated meaningful correlation between sperm retrieval rate (SRR) and testis histology (p<0.001). The LIM15 gene expression level measured in ejaculate significantly correlated with the SRR in mTESE (p = 0.039). As shown in Figure 1, the maximal sensitivity (50%) and specificity (87%) were obtained for the LIM15 gene with a cutoff point of 4.61 and AUC of 0.65. Conclusions According to our results, LIM15 measured in the ejaculate before the second mTESE can provide information on sperm retrieval and reduce the potential complications and unnecessary costs associated with assisted reproductive techniques. Disclosure No
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