Correlation of Seminal Plasma EMMPRIN Levels with Sperm Quality and the Efficacy of Activation Techniques

Background: Infertility is a major global health challenge, impacting 15% to 20% of couples globally. Male infertility, which is typically associated with issues such as low sperm motility, has increased during the last two decades. Male fertility relies heavily on the development of extracellular matrix metalloproteinase inducer (EMMPRIN), a glycosylated transmembrane protein involved in sperm function and embryo implantation. Understanding how sperm preparation techniques affect sperm quality and EMMPRIN expression is crucial for achieving optimal results in assisted reproductive technologies (ART). Objective: To investigate EMMPRIN expression in human sperm and compare the impact of two in vitro sperm preparation procedures, “direct swim-up (DSU) and pellet swim-up (PSU), on various sperm characteristics. To determine the optimum technique for improving sperm quality in ART. Materials and Methods: Masturbation was employed to collect sperm samples from 44 participants (aged 21 to 45). Following liquefaction, samples were evaluated macroscopically and microscopically in accordance with WHO 2021 guidelines. The samples were separated into three aliquots for ELISA assessment of EMMPRIN levels and sperm processing with DSU and PSU techniques. Sperm chromatin immaturity (SCI) was assessed using Aniline Blue staining. Statistical investigations were carried out to determine the correlations between EMMPRIN levels, semen parameters, and the impacts of the two in vitro sperm preparation techniques. Results: Sperm concentration significantly decreased from control (40.25 ± 2.30) to DSU (15.51 ± 1.74) and PSU (9.99 ± 1.16) conditions. However, motility, morphology, and SCI significantly improved, particularly with PSU, which showed a greater reduction in SCI % compared to DSU, indicating its effectiveness in selecting higher-quality sperm. There were no significant associations detected between EMMPRIN levels with semen metrics, although PSU exhibited a slightly higher association with improved sperm parameters. Conclusion: Seminal plasma EMMPRIN levels do not appear to directly influence semen parameters or sperm chromatin maturity. However, the choice of sperm activation technique, particularly PSU, significantly impacts sperm quality. More research is needed to better understand the importance of EMMPRIN in ART outcomes and its potential as a sperm quality indicator.