Abstract
The interaction of spermatozoa with epididymal secretions appears to be essential for fertilization. Sequential changes to the spermatozoa take place during their transit through the epididymis due in part to their interaction with secreted proteins. Specifically, the ability of spermatozoa to bind to the zona pellucida is achieved during epididymal transport and maturation as the membrane protein P34H accretes to the acrosomal cap. The purpose of our study was to compare the frequency of epididymal protein P34H deficiency in a population of men undergoing routine fertility evaluation in comparison to men with proven fertility. Prospective analysis of patients presenting to clinical andrology laboratory. Following Institutional Research Ethics Board approval, semen samples from 105 men undergoing fertility evaluation and 108 healthy men with proven fertility were analyzed. The Western blot analyses were performed to determine the level of epididymal protein P34H. Protein levels under 30% were considered deficient. In the group of 105 men presenting for fertility evaluation, 14 (13.3%) were P34H deficient as compared to only 1 (0.9%) P34H deficient result in the fertile control group of 108 men. The Fisher's exact test revealed that the proportion of P34H deficient cases was significantly greater in the group of men undergoing fertility evaluation compared to the fertile controls (P<0.0001). The observed power of this test was 96.7% to yield a statistically significant result at the 0.05 significance level. In addition the Spearman's rank test did not identify a significant correlation between the standard semen parameters of volume, concentration, motility, morphology and viability and the level of P34H protein. This is the first study to evaluate the presence of epididymal P34H protein in men undergoing fertility assessment in a clinical andrology laboratory setting. Our results suggest that a significant proportion of men investigated for male infertility may be epididymal protein P34H deficient. Evaluation of protamine P34H may aid in the assessment of the epididymal maturation status of the spermatozoa and help to select the appropriate treatment option for infertile couples.
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