The Frequency of Chromosomal Abnormalities and Y Chromosome Microdeletions in Infertile Non-Obstructive Azoospermic and Severe Oligozoospermic Males

M. Abdel-Razek, E. Elsobky, Y. Moustafa, Moustafa A. Elsaied, Shreif Refaat
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Abstract

ABSTRACT Purpose: To estimate the frequency and types of both chromosomal abnormalities and Azoospermia Factor (AZF) microdeletions among patients with non-obstructive azoospermia (NOA) and severe oligozoospermia (SOZ) with sperm count less than 5 million/ml. Methods: Karyotyping was performed for all 1127 patients, whereas AZF microdeletions assay was done for 811 patients including 653 NOA and 158 SOZ by multiplex polymerase chain reaction (PCR). All patients were subjected to clinical examination, scrotal duplex ultrasound and hormonal evaluations. Results: The frequency of chromosomal abnormalities was 14.4%, higher in NOA than SOZ men (22.6% versus 3.7%). Numerical chromosomal abnormalities were higher than structural type (11.8% versus 2.4%). Klinefelter syndrome (KS) represented 11.2% of the total chromosomal and 94.1% of sex chromosomal abnormalities. AZF microdeletions were higher in NOA than SOZ (6.1% versus 3.16%). AZFc microdeletions represented the most frequent finding: 31/45 (68.9%), followed by AZFbc: 7/45(15.6%), AZFb: 4/45 (8.8%) and AZFa: 3/45 (6.7%). All patients with AZFa (3), AZFb (4) and AZFbc (7) deletions were NOA, while 26/31(83.87%) with isolated AZFc deletion were NOA and 5/31(16.13%) were SOZ. Conclusion: In according to the results shown, we emphasize the importance of karyotyping and AZF microdeletions analysis in such groups. Counseling for such patients before ARTs is warranted to decrease the risk of transmitting genetic abnormalities to off spring.
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非阻塞性无精子和严重少精子不育男性染色体异常和Y染色体微缺失的频率
【摘要】目的:评估精子数量小于500万/ml的非阻塞性无精子症(NOA)和严重少精子症(SOZ)患者染色体异常和无精子症因子(AZF)微缺失的频率和类型。方法:对1127例患者进行核型分析,对811例患者进行AZF微缺失检测,其中NOA患者653例,SOZ患者158例。所有患者均接受临床检查、阴囊双工超声及激素评估。结果:NOA组染色体异常发生率为14.4%,高于SOZ组(22.6%比3.7%)。数值型染色体异常高于结构型(11.8%比2.4%)。Klinefelter综合征(KS)占总染色体的11.2%,占性染色体异常的94.1%。NOA组AZF微缺失高于SOZ组(6.1% vs . 3.16%)。AZFc微缺失最多,为31/45(68.9%),其次是AZFbc: 7/45(15.6%)、AZFb: 4/45(8.8%)和AZFa: 3/45(6.7%)。AZFa(3)、AZFb(4)和AZFbc(7)缺失的患者均为NOA,而AZFc缺失的26/31(83.87%)为NOA, 5/31(16.13%)为SOZ。结论:根据上述结果,我们强调对这类人群进行核型分析和AZF微缺失分析的重要性。在进行抗逆转录病毒治疗之前,对这些患者进行咨询是有必要的,以减少遗传异常传给后代的风险。
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