Severe oligozoospermia resulting from deletions of azoospermia factor gene on Y chromosome

Abstract

Background: About 13% of cases of non-obstructive azoospermia are caused by deletion of the azoospermia factor (AZF), a gene or gene complex normally located on the long arm of the Y chromosome. Oligozoospermia is far more common than azoospermia, but little is known about genetic causes. We investigated whether severe oligozoospermia is caused by AZF deletions and, if so, whether those deletions are present in mature spermatozoa.

Methods: By PCR, we tested leucocyte DNA, from 35 men who presented at infertility clinics and who had severe oligozoospermia, for the presence of 118 DNA landmarks scattered across the Y chromosome. In the two men in whom Y-chromosome deletions in leucocyte DNA were detected, we also tested leucocyte DNA from the individuals' fathers, and in one man we tested sperm DNA.

Findings: In two men with ejaculate sperm counts of 40 000-100 000 per mL, we detected Y-chromosome deletions in leucocyte DNA similar in location to those previously reported in azoospermic individuals. No Y-chromosome deletions were detected in the fathers of the two men. For one of the two men, sperm DNA was tested, and it showed the same Y-chromosome deletion seen in leucocytes.

Interpretation: The Y-chromosome deletions in these two men are de-novo mutations, and are therefore the cause of their severe oligozoospermia. Not only is the absence of AZF compatible with spermatogenesis, albeit at reduced rate, but also the resultant sperm bear the mutant Y chromosome. Because intracytoplasmic sperm injection is increasingly used as a means of circumventing oligozoospermia, AZF deletions could be transmitted by this practice, and would probably result in infertile sons. In cases of severe oligozoospermia, it may be appropriate to offer Y-DNA testing and genetic counselling before starting assisted reproductive procedures.