Background: Azoospermia is a very severe form infertility in males. Today, clinicians depend on semen analyses for the prediction of the reproductive potential of males, and testicular biopsies are the only reliable methods for diagnosing various subtypes of azoospermia. In the recent times, advances in proteomics contributed to look for new infertility biomarkers in males whose seminal plasma proteins are rich with proteins of various genital tract origins. Therefore, the fields of proteomics helped to develop new infertility biomarkers in males. Extracellular Matrix Protein 1 and Seminal plasma proteins Testis Expressed Protein 101 assays currently existing of are under the last development for the purpose of clinical uses. Therefore, this study aimed to assesses the capability of Testis Expressed Protein 101 and Extracellular Matrix Protein 1, Seminal Plasma proteins, for differential diagnosing between Obstructive azoospermia from non-obstructive azoospermia by noninvasive methods. A case control study was conducted on 40 infertile azoospermia males who were clinically examined, having their seminal fluid analyzed and hormonally investigated and SP proteins Testis Expressed Protein 101 and Extracellular Matrix Protein 1 were assessed. Other fifty healthy fertile men were included as control group. Results: The studied biomarkers were significantly lower in non-obstructive azoospermia then Obstructive azoospermia were had higher level, and the control group participants were higher than the others. Conclusion: Extracellular Matrix Protein 1 and Testis-expressed 101 protein should combined and could make a differences between non-obstructive azoospermia and obstructive azoospermia thus eliminating most of the diagnostic testicular biopsies. Seminal plasma needs for pre- treatment before processing for diagnose any biomarker specially to differentiate between obstructive azoospermia and non-obstructive azoospermia. By the cutoff value of 2.3 μg/ml for Extracellular Matrix Protein 1 obstructive azoospermia and normal spermatogenesis are distinguished with 100% specificities, and obstructive azoospermia from non-obstructive azoospermia with 73% specificities, 100% sensitivities. Yet Testis Expressed Protein 101 lack could help distinguishing the non-obstructive azoospermia in specifics.


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