Korean J Urol.  2013 Aug;54(8):536-540. 10.4111/kju.2013.54.8.536.

Success Rate of Microsurgical Multiple Testicular Sperm Extraction and Sperm Presence in the Ejaculate in Korean Men With Y Chromosome Microdeletions

Affiliations
  • 1Department of Urology, Cheil General Hospital & Women's Healthcare Center, Kwandong University College of Medicine, Seoul, Korea. jtandro@cgh.co.kr

Abstract

PURPOSE
We assessed the frequency of azoospermia factor a (AZFa), AZFb, and AZFc deletions and examined correlations between the deletion sites and the success rates of sperm presence within the ejaculate and surgical sperm retrieval in Korean men.
MATERIALS AND METHODS
A total of 1,919 azoospermic and severely oligozoospermic men were assessed for Y chromosome microdeletions. Among them, 168 men with AZF deletions were identified and their medical records were reviewed.
RESULTS
Of the total 168 men with AZF deletions, there were 13 with AZFa, 10 with AZFb, 95 with AZFc, 37 with AZFbc, and 13 with AZFabc deletions. Of the 95 men with isolated AZFc deletion, 51 had the presence of sperm in the ejaculate. Of the infertile men with any other deletion, however, only two patients (one man with AZFb deletion and another with AZFbc deletion) showed the presence of sperm in the ejaculate. The success rates for surgical sperm retrieval were 7.1% (1/14) in men with AZFbc deletion and 54.8% (17/31) in the isolated AZFc deletion group. No sperm was obtained from the patients with AZFa or AZFb deletions who underwent microsurgical sperm retrieval. In the isolated AZFc deletion group, there were significant differences between azoospermic and severely oligozoospermic patients in terms of testicular volume and serum levels of follicle-stimulating hormone and luteinizing hormone, whereas no significant differences were found when the group was divided by surgical sperm retrieval outcomes.
CONCLUSIONS
Deletions of the AZFa and AZFb regions are associated with severe spermatogenetic impairment. However, more than half of men with an AZFc deletion had sperm within the ejaculate or testis for in vitro fertilization with intracytoplasmic sperm injection.

Keyword

Azoospermia; Infertility; Male; Y chromosome

MeSH Terms

Azoospermia
Chromosome Deletion
Chromosomes, Human, Y
Fertilization in Vitro
Follicle Stimulating Hormone
Humans
Infertility
Luteinizing Hormone
Male
Medical Records
Sex Chromosome Aberrations
Sex Chromosome Disorders of Sex Development
Sperm Injections, Intracytoplasmic
Sperm Retrieval
Spermatozoa
Testis
Vitamin B 12
Y Chromosome
Chromosome Deletion
Chromosomes, Human, Y
Follicle Stimulating Hormone
Luteinizing Hormone
Sex Chromosome Aberrations
Sex Chromosome Disorders of Sex Development
Vitamin B 12
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