A New Sperm Concentration Threshold for Y Chromosome Microdeletion Analysis in Infertile Men: Could It Be Azoopermia?

0 UROLOGY & NEPHROLOGY Urology research & practice Pub Date : 2024-10-21 DOI:10.5152/tud.2024.24061
Ali Çift, Can Benlioğlu, Mehmet Özgür Yücel, Muhammer Özgür Çevik, Bedreddin Kalyenci, Alper Gök, Sait Sever, Hasan Sulhan, Haydar Bağış, Ali Ayyıldız
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Abstract

Objective: We aimed to assess the frequency of Y-chromosome microdeletions (YCMs) in a non-multiethnic urban population in our region, define predictive factors, and determine a new clinical threshold for YCMs in infertile men.

Materials and methods: A total of 281 patients with a sperm concentration ≤5 million/mL were retrospectively evaluated. Oligozoospermic and/or azoospermic patients with a sperm concentration of ≤5 million/mL were screened for the YCM analysis.

Results: Y-chromosome microdeletion was detected in 9 (3.2%) of the 281 patients. All patients with YCM were azoospermic. The presence of azoospermia, a high folliclestimulating hormone level, and a high luteinizing hormone level were found to be important determinants for the identification of a microdeletion (P = .002, P = .002, and P=.021, respectively). If the presence of azoospermia and a sperm concentration threshold of <1 million/mL had been applied for the YCM test, the number of tests performed would have been reduced by 54.4% (153 tests) and 42.7% (120 tests), respectively, resulting in cost saving of approximately $11 474 and $9000, respectively.

Conclusion: We recommend that the threshold for sperm concentration for YCM analysis be set at <1 million in individuals in developed countries and only in patients with azoospermia in developing countries, in order to reduce costs and save labor by excluding unnecessary tests. These proposed thresholds (azoospermia and sperm counts less than <1 million/mL) provide cost-effectiveness by significantly reducing the number of genetic tests ordered without affecting the diagnosis rate.

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用于不育男性 Y 染色体微缺失分析的新精子浓度阈值:可能是无精症吗?
目的我们旨在评估本地区非多民族城市人口中 Y 染色体微缺失(YCMs)的频率,确定预测因素,并确定不育男性 YCMs 的新临床阈值:对精子浓度≤500 万/毫升的 281 名患者进行了回顾性评估。筛选精子浓度≤500 万/毫升的少精子症和/或无精子症患者进行 YCM 分析:结果:281 名患者中有 9 人(3.2%)被检测出 Y 染色体微缺失。所有 YCM 患者均为无精子症患者。发现无精子症、高卵泡刺激素水平和高黄体生成素水平是确定微缺失的重要决定因素(分别为 P = .002、P = .002 和 P=.021)。如果存在无精子症,且精子浓度阈值为 结论:我们建议将 YCM 分析的精子浓度阈值设定为
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