title: Heat shock factor Y chromosome (HSFY) mRNA level predicts the presence of retrievable testicular sperm in men with nonobstructive azoospermia.
abstract: OBJECTIVE
  To evaluate heat shock factor Y chromosome (HSFY) mRNA as a biomarker for the presence of retrievable testicular sperm.
  
  
  METHODS
  Case-control study.
  
  
  METHODS
  Academic medical center.
  
  
  METHODS
  Men with nonobstructive azoospermia (NOA).
  
  
  METHODS
  Testicular tissue from men with successful or failed testicular sperm extraction was evaluated with qunatitative real-time polymerase chain reaction (qRT-PCR) for expression of HSFY mRNA.
  
  
  METHODS
  Area under the receiver operating characteristic curve (AUC), sensitivity, specificity, and probability of sperm retrieval based on HSFY testing.
  
  
  RESULTS
  We found higher HSFY mRNA expression in testicular tissue from NOA patients in whom sperm were successfully retrieved compared with those in whom sperm were not found, with good discrimination between the groups in all histologic variants of NOA (AUC 0.89 overall, 0.98 for patients with Sertoli cell only [SCO] histology, 0.90 for patients with maturation arrest [MA] histology). Sensitivity and specificity were, respectively, 67% and 93% overall, 92% and 100% for SCO patients, and 67% and 92% for MA patients. The probabilities of sperm retrieval for HSFY-positive and -negative patients were, respectively, 93% and 31% overall, 100% and 7% for SCO patients, and 91% and 32% for MA patients.
  
  
  CONCLUSIONS
  Detection of HSFY mRNA expression by qRT-PCR has promising application in the evaluation and counseling of men with NOA before attempted sperm retrieval surgery.
authors.affiliation: Department of Urology, Weill Cornell Medical College, New York, New York, USA. pjs2002@med.cornell.edu
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Stahl
authors.forename: Anna
authors.initials: A
authors.lastname: Mielnik
authors.forename: Peter N
authors.initials: PN
authors.lastname: Schlegel
authors.forename: Darius A
authors.initials: DA
authors.lastname: Paduch
mesh_terms: D000046:Academic Medical Centers; D000328:Adult; D053713:Azoospermia / Q000235:genetics / Q000473:pathology / Q000601:surgery*; D001706:Biopsy; D016022:Case-Control Studies; D041322:Chromosomes, Human, Y; D004268:DNA-Binding Proteins / Q000235:genetics*; D005819:Genetic Markers; D000076249:Heat Shock Transcription Factors; D006801:Humans; D008297:Male; D042282:Microdissection; D009519:New York City; D016133:Polymerase Chain Reaction; D011237:Predictive Value of Tests; D012333:RNA, Messenger / Q000032:analysis*; D012372:ROC Curve; D013076:Sperm Count; D053625:Sperm Retrieval; D013094:Spermatozoa / Q000378:metabolism* / Q000473:pathology; D013737:Testis / Q000378:metabolism / Q000473:pathology / Q000601:surgery*; D014157:Transcription Factors / Q000235:genetics*
chemical_list: D004268:DNA-Binding Proteins; D005819:Genetic Markers; D000076249:Heat Shock Transcription Factors; D012333:RNA, Messenger; D014157:Transcription Factors