Predictive value of miR-122-5p, miR-449a, miR-30b-5p, miR-34c-5p, miR-34b-5p in sperm recovery from testicular tissue of azoospermic infertile men

<ns3:p> Background Infertility is a global health issue affecting approximately 15% of couples, with male factors contributing to nearly half of the cases. Azoospermia remains a major challenge in male infertility diagnosis and treatment. Current diagnostic methods rely on invasive techniques such as testicular biopsy, which carry risks of tissue damage. MicroRNAs (miRNAs), small non-coding RNAs involved in gene regulation, have emerged as potential non-invasive biomarkers for assessing spermatogenesis. This study aimed to evaluate the predictive value of <ns3:italic>miR-122-5p</ns3:italic> , <ns3:italic>miR-449a</ns3:italic> , <ns3:italic>miR-30b-5p</ns3:italic> , <ns3:italic>miR-34c-5p</ns3:italic> , and <ns3:italic>miR-34b-5p</ns3:italic> in sperm retrieval success from testicular tissue in azoospermic infertile men. Methods The azoospermic male patients were recruited, including a group with obstructive azoospermia (OA) and a group with non-obstructive azoospermia (NOA). Patients with a history of drug use, smoking, alcohol consumption, or systemic diseases were excluded. Testicular biopsy samples were collected using microdissection testicular sperm extraction (micro-TESE). The expression levels of selected miRNAs were assessed using quantitative real-time polymerase chain reaction (qRT-PCR), with normalization to SNORD-47. Statistical analysis was conducted using SPSS, with significance set at P &lt; 0.05. Results The expression levels of <ns3:italic>miR-34b-5p</ns3:italic> , <ns3:italic>miR-449a</ns3:italic> , and <ns3:italic>miR-30b-5p</ns3:italic> were significantly lower in azoospermic patients compared to controls, suggesting their role in impaired spermatogenesis. Conversely, <ns3:italic>miR-34c-5p</ns3:italic> showed a slight upregulation in the case group, potentially indicating a compensatory mechanism in sperm maturation. <ns3:italic>miR-122-5p</ns3:italic> expression remained relatively unchanged between groups. Cycle threshold (Ct) and ΔCt analysis further validated these differences, emphasizing the potential role of <ns3:italic>miR-34b-5p</ns3:italic> , <ns3:italic>miR-449a</ns3:italic> , and <ns3:italic>miR-30b-5p</ns3:italic> in predicting sperm recovery from testicular tissue. Conclusion The differential expression of <ns3:italic>miR-34b-5p</ns3:italic> , <ns3:italic>miR-449a</ns3:italic> , and <ns3:italic>miR-30b-5p</ns3:italic> suggests their potential utility as biomarkers for predicting sperm retrieval success in azoospermic men, whereas <ns3:italic>miR-122-5p</ns3:italic> appears to have limited predictive value. Further studies with larger cohorts are required to validate these findings and explore their clinical applications in non-invasive male infertility diagnostics. </ns3:p>