Y-chromosome microdeletions in nonobstructive azoospermia and severe oligozoospermia

authors	Goncalves, C; Cunha, M; Rocha, E; Fernandes, S; Silva, J; Ferraz, L; Oliveira, C; Barros, A; Sousa, M
nationality	International
journal	ASIAN JOURNAL OF ANDROLOGY
author keywords	intracytoplasmic sperm injection; newborn outcomes; sperm extraction; Y-chromosome microdeletions
keywords	INTRACYTOPLASMIC SPERM INJECTION; MALE FACTOR INFERTILITY; CELL-ONLY-SYNDROME; DELETION ANALYSIS; AZFC REGION; MEN; SPERMATOGENESIS; GENES; ICSI; FERTILITY
abstract	The aim of the present work was to present the outcomes of the patients with Y-chromosome microdeletions treated by intracytoplasmic sperm injection (ICSI), either using fresh (TESE) or frozen-thawed (TESE-C) testicular sperm and ejaculated sperm (EJAC). The originality of this work resides in the comparisons between the different types of Y-microdeletions (AZFa, AZFb, and AZFc) and treatments, with detailed demographic, stimulation, embryological, clinical, and newborn (NB) outcomes. Of 125 patients with Y-microdeletions, 33 patients presented severe oligozoospermia (18 performed ICSI with ejaculated sperm) and 92 secretory azoospermia (65 went for TESE with 40 having successful sperm retrieval and performed ICSI). There were 51 TESE treatment cycles and 43 TESE-C treatment cycles, with a birth of 19 NB (2 in AZFaITESE-C, 12 in AZFc/TESE, and 5 in AZFc/TESE-C). Of the 29 EJAC cycles, there was a birth of 8 NB (in AZFc). In TESE and EJAC cycles, there were no significant differences in embryological and clinical parameters. In TESE-C cycles, there was a significant lower oocyte maturity rate, embryo cleavage rate and mean number of embryos transferred in AZFb, and a higher mean number of oocytes and lower fertilization rate in AZFc. In conclusion, although patients with AZFc microdeletions presented a high testicular sperm recovery rate and acceptable clinical outcomes, cases with AZFa and AZFb microdeletions presented a poor prognosis. Due to the reported heredity of microdeletions, patients should be informed about the infertile consequences on NB and the possibility of using preimplantation genetic diagnosis for female sex selection.
publisher	MEDKNOW PUBLICATIONS & MEDIA PVT LTD
issn	1008-682X
year published	2017
volume	19
issue	3
beginning page	338
ending page	345
digital object identifier (doi)	10.4103/1008-682X.172827
web of science category	Andrology; Urology & Nephrology
subject category	Endocrinology & Metabolism; Urology & Nephrology
unique article identifier	WOS:000400828700013