Seminal Oligouridinosis: Low Uridine Secretion as a Biomarker for Infertility in Spinal Neurotrauma

Abstract

Compromised sexual health is a major rehabilitative barrier for men with lower-spinal cord injury (SCI). Although studies have revealed decreased sperm motility, the quantitative biochemical changes that underlie the infertility mechanism remain poorly understood. We employed a nontargeted approach combining 800 MHz hydrogen nuclear magnetic resonance ((1)H NMR) spectroscopy and ultra-performance liquid chromatography-mass spectrometry (UPLC-MS) with pattern recognition methods to analyze seminal fluid metabolite profiles in 10 men with and 8 without SCI above thoracic vertebra 10 (T10). The metabolic phenotype for SCI could be predicted from the (1)H NMR data. The median concentration of uridine in fertile controls was 1.55 mmol/L (range 1.0-5.0 mmol/L), but was undetectable by both NMR and MS in all but 2 individuals from the SCI group, one who later fathered a child without assisted fertility techniques. We hypothesize that uridine is likely to be an essential precursor to metabolites required for capacitation and is a potential marker for the prognosis of post-SCI functional fertility recovery. We derived the term "seminal oligouridinosis" to describe this newly identified condition.