Relationship between testicular sperm extraction results and AZF gene mutations

Abstract

Abstract

Objective: In this study, the effects of testicular sperm extraction (TESE) outcome on Y microdeletion, caryotype analysis, and pathology results in azoospermic infertile male patients were investigated.

Materials and methods: A total of 165 azoospermic infertile male patients who underwent TESE between January 2008-December 2009 in Ege University Faculty of Medicine, Urology Department have been evaluated for medical history, physical examination, spermiogram, caryotype analysis, Y chromosome microdeletion, FSH level, and TESE outcome regarding sperm availability.

Results: Mean age of patients was 34±5.42 years, mean time of infertility was 73±57.7 months, and infertility type was primary in 98.8% of cases. Mean testicular volume was 12.3 cc, and varicocele was detected in 32 patients. Mean FSH level was 17 IU/mL. In 10 of the cases AZFc deletion, in 1 case AZFb deletion and in 1 case both deletions were identified. Number of patients underwent microTESE and conventional TESE were 109 and 56, respectively. Regarding the pathological outcomes, 91 (55.2%) cases were germinal cell aplasia, 32 (19.4%) cases were maturation arrest, 23 (13.9%) cases were normal spermatogenesis, 10 (6.1%) cases were tubulary sclerosis, 9 (5.5%) cases were hipospermatogenesis. The cases in which Y microdeletion was present, pathological outcome was 75% germinal cell aplasia and 25% maturation arrest. Sperm avaliability was present in 37.5% of all cases, and this ratio was 27.2% in the cases with AZFc mutation.

Conclusion: TESE operation is a method that can be applied successfully in the treatment of azospermia. Detection of the AZF gene mutations is useful to predict a negative TESE outcome.