Hashemi MS, et al. - Since cell-free seminal mRNA (cfs-mRNA) exists in the human ejaculate proposed as a potential noninvasive procedure for the prognosis of pathophysiological conditions, researchers used cfs-mRNA of ESX1, ZMYND15 and its target haploid genes (TNP1 and PRM1) to detect the presence of spermatozoa in men with azoospermia. Thirty-five semen samples from 16 normozoospermic and 19 nonobstructive azoospermic people were involved. Compared with normozoospermia, the expression level of these genes (ZMYND15, TNP1 and PRM1) was significantly reduced in semen samples of nonobstructive azoospermia. Likewise, the expression level of TNP1 and PRM1 in the sample with negative sperm (SR−) relative to positive sperm retrieval (SR+) decreased significantly. Based on the receiver operating characteristics curve analysis, the expression level of these genes may have the potential to predict successful sperm retrieval with high sensitivity and specificity.