Seminal plasma characteristics as indicators of cystic fibrosis transmembrane conductance regulator (CFTR) gene mutations in men with obstructive azoospermia

Objective: To determine the prognostic value of seminal plasma volume, pH, fructase, and alpha-glucosidase for the detection of cystic fibrosis transm embrane conductance regulator (CFTR) gene mutations. Design: Retrospective data analysis. Setting: University infertility clinic (referral center). Patient(s): Fifty-nine men with obstructive azoospermia. Intervention(s): S emen analysis including seminal plasma volume, pH, fructose, alpha-glucosid ase, molecular genetic diagnosis of CFTR mutations and FSH measurement. Main Outcome Measure(s): Sensitivity and specificity of seminal plasma mark ers for the detection of CFTR mutations. Result(s): A CFTR mutation was detected in 26 of 59 patients with obstructi ve azoospermia. Patients carrying a mutation had significantly lower semina l plasma volume (mean +/- SEM: 1.5 +/- 1.4 mL, vs. 2.8 +/- 2.2 mL), lower p H levels (25th percentile, median, 75th percentile: 6.5, 6.8, 7.5 vs. 7.7, 7.9, 7.9) and lower fructose content (1.0, 1.1, 3.7 vs. 5.8, 20.0, 83.0 mu mol/ejaculate) than those without mutations. Diagnostic efficacy for detect ion of mutations was best (pH 81.4%, fructose 81.8%) at a cutoff level for pH of 7.4 and fructose of 2 mu mol/ejaculate. Conclusion(s): Seminal plasma markers provide an effective, noninvasive met hod to predict CFTR mutations in men with obstructive azoospermia. ((C) 200 0 by American Society for Reproductive Medicine.)