Male Fertility Male Endocrine and Genetic Factors

Association of partial AZFc region deletions with spermatogenic impairment and male infertility

Ferlin A, Tessari A, Ganz F, Marchina E, Barlati S, Garolla A, Engl B, Foresta C

Published March 2005 Journal of medical genetics
DOI 10.1136/jmg.2004.025833 PMID 15744033 PMC PMC1736009

RRM Academy Synopsis

Some partial AZFc deletions are linked to male infertility

A 2005 study compared 337 Italian men with low or absent sperm to 263 fertile men. Partial AZFc deletions on the Y chromosome were more common in the infertile men. About 5 out of 100 infertile men carried one, against fewer than 1 out of 100 fertile men. Deletions removing DAZ1/DAZ2 appeared linked to infertility.

Key Findings

  • Partial AZFc deletions were found in 18 of 337 infertile men (5.3%) and in 1 of 263 fertile men (0.4%), a difference with p<0.001.
  • The gr/gr deletion was found in 16 of 337 infertile men (4.7%) and 1 of 263 fertile men (0.4%). One infertile man had a b2/b3 deletion; one had a novel b3/b4 deletion.
  • The gr/gr deletion that removes DAZ1/DAZ2 was found in 10 of 337 infertile men (3.0%) and in 0 of 263 fertile men (p<0.05).
  • The gr/gr deletion that removes DAZ3/DAZ4 was found in 6 of 337 infertile men (1.8%) and 1 of 263 fertile men (0.4%), a difference that was not significant.
  • Partial AZFc deletions appeared in 3 of 73 men with no sperm in the ejaculate (4.1%), 11 of 193 with severe oligozoospermia (5.7%), and 4 of 71 with moderate oligozoospermia (5.6%).

Interpretation

This case-control study examined Caucasian men from northern Italy and found an association between partial AZFc deletions and infertility. Men with a deletion had semen results ranging from no sperm to moderately low sperm counts. The authors note that one family's father and brother with the DAZ3/DAZ4 deletion had fathered children naturally, though they say a subtle effect of this deletion cannot be excluded. The findings support larger studies of AZFc deletion screening in infertile men.

RRM Context

Male factor contributes to infertility in many couples. A Y chromosome deletion is one diagnosable cause of a low sperm count. Restorative reproductive medicine looks for the cause in both partners before choosing a response. A named cause replaces the label of unexplained infertility. The authors warn that IVF using sperm from a man with one of these deletions may pass the deletion on to sons.

Abstract

Background

Complete deletions of the AZFc region in distal Yq are the most frequent molecular genetic cause of severe male infertility. They are caused by intrachromosomal homologous recombination between amplicons--large, nearly identical repeats--and are found in 5-10% of cases of azoospermia and severe oligozoospermia. Homologous recombination may also generate different partial deletions of AZFc, but their contribution to spermatogenic impairment has not been confirmed.

Methods

In this study we analysed the prevalence and characteristics of different partial AZFc deletions and their association with spermatogenic failure. We studied 337 infertile men with different spermatogenic impairment and 263 normozoospermic fertile men using AZFc specific sequence tagged site markers and DAZ specific single nucleotide variants.

Results

We identified 18 cases of partial AZFc deletions in the infertile group (5.3%) and one case in the control group (0.4%). Seventeen deletions had the "gr/gr" pattern, one the "b2/b3" pattern, and one represented a novel deletion with breakpoints in b3 and b4 amplicons. Partial AZFc deletions were associated with different spermatogenic phenotypes ranging from complete azoospermia to only moderate oligozoospermia.

Conclusions

Together with published data, our analysis of DAZ gene copy suggested that the contribution of the different deletions to male infertility varies: only partial AZFc deletions removing DAZ1/DAZ2 seem to be associated with spermatogenic impairment, whereas those removing DAZ3/DAZ4 may have no or little effect on fertility. These data show that, beside complete AZFc deletions, specific partial deletions represent a risk factor for male infertility, even if with different effect on spermatogenesis.

Topics

By this author

Related research

Male Fertility › Male Endocrine and Genetic Factors › Genetic Causes of Male Infertility · Genetics and Immunology › Reproductive Genetics › Chromosomal Abnormalities
PMID 15744033 15744033 DOI 10.1136/jmg.2004.025833 10.1136/jmg.2004.025833 Ferlin et al. 2005, Ferlin 2005