Analysis of fertility potential in men with severe azoospermia and oligospermia of various etiology

• Published in: Andrologii͡a︡ i genitalʹnai͡a︡ khirurgii͡a Vol. 19; no. 3; pp. 60 - 69
• Main Authors: Yamandi, T. A., Akulenko, L. V., Safina, N. Yu, Vityazeva, I. I., Bogolubov, S. V., Melnik, Ya. I., Kasatonova, E. V., Polyakov, A. V., Andreeva, M. V., Chernykh, V. B.
• Format: Journal Article
• Language: English
• Published: ABV-press 30.11.2018
• Subjects: azf locus; chromosomal anomalies; deletions; human reproduction; in vitro fertilization; ivf/icsi; male infertility; testicular biopsy; y chromosome
• ISSN: 2070-9781; 2412-8902
• DOI: 10.17650/2070-9781-2018-19-3-60-69

The study objective is to evaluate the significance of the Y chromosome microdeletions for prediction of spermatozoa retrieval during testicle biopsy in men with severe azoospermia and oligozoospermia. Materials and methods . In total, 109 men aged 21 to 56 years (mean age 32.7 ± 0.2 years) with infertility in marriage were examined. Cytogenetic, special andrological, spermiological, and molecular genetic examinations were performed to evaluate non-genetic and genetic causes of infertility. Results . Normal karyotype and absence of AZF deletions were found in 75 men, presence of deletions – in 34. The frequencies of pathozoospermia forms were comparable in these groups. Spermatozoa were retrieved during biopsy in 47 (62.7 %) patients without Y chromosome microdeletions and only in 7 (20.6 %) patients with Y chromosome microdeletions. The men with AZF deletions were divided into 2 subgroups: men with complete AZF region deletions (n = 25) and men with partial AZF deletions (n = 9). Among men with complete deletions, azoospermia was diagnosed in 25 (100 %), spermatozoa were retrieved during biopsy in 2 (8 %); among men with partial deletions, azoospermia was diagnosed in 7 (77.8 %), severe oligozoospermia in 2 (22.2 %), spermatozoa were retrieved during biopsy in 5 (56 %). Then the patients were divided according to another criterion: 54 patients from whom spermatozoa were retrieved during biopsy and 55 men with negative results. Among patients with successful result of biopsy, Y chromosome microdeletions were identified in 7 (13 %); among patient with negative biopsy result – in 27 (49 %) (р < 0.01). Conclusion. Success rate of spermatozoa retrieval during testicle biopsy is significantly higher in men without AZF deletions (р < 0.01) than in men with deletions. Molecular genetic examination of Y chromosome microdeletions is recommended for men with azoospermia and severe oligozoospermia because it allows diagnosing of cause male infertility and predicting.