无精子症和重度少精子症不育患者Y染色体微缺失率的临床研究

目的对本院男性不育患者的Y染色体长臂上的AZF区进行微缺失检测,研究Y染色体AZF区的微缺失与男性患者不育的相关性。方法回顾性分析2012年4月至2014年4月来我院进行诊治的296例无精子症患者和320例重度少精子症患者,比较Y染色体在无精子症和重度少精子症患者中的缺失率。结果 616例不育男性患者中检出69例AZF区不同程度微缺失,缺失率为11.6%。无精子症患者发生的缺失概率高于重度少精子症患者,无精子症患者中AZF区缺失率为15.2%,重度少精子症患者AZF区缺失率为7.5%。AZF区缺失高频发生于AZFc区,占总缺失的60.9%。结论 Y染色体微缺失在无精子症和重度少精子症患者发生率较高,进行辅助生殖治疗前应进行微缺失检测。     

特发性无精子症和严重少精子症患者无精子因子的检测及其意义

目的：探讨引起特发性无精子和严重少精子造成男性不育的遗传学原因和检测无精子因子(AZF)的临床意义。方法：对50例特发性男性不育患者(不育组)和50例正常生育者(对照组)的外周血标本．提取基因组DNA,通过多重聚合酶链反应检测Y染色体AZt?微缺失。结果：对照组均可见SRY、SY84、SY86、YRRM1(RBM1)和SY254(DAZ)扩增带。不育组6例(无精子症4例．严重少精子症2例)可见SRY扩增带．但未见SY254扩增带,其中2例同时未见YRRM。扩增带;1例仅未见YRRM。扩增带。结论：Y染色体AZF微缺失是引起无精子和严重少精子并造成男性不育的重要原因之一;AZF微缺失检测对男性不育症患者进行遗传学诊断与筛查有一定意义。     

原发性无精子症与严重少精子症患者AZF微缺失筛查

目的:观察Y染色体AZF微缺失与原发性无精子症和严重少精子症之间的关系。方法:所有筛选入实验组的研究对象均进行外周血生殖内分泌激素卵泡刺激素(FSH)、黄体生成素(LH)、睾酮(T)的检测及染色体核型分析,排除激素水平异常者及染色体结构与数目异常者。将符合纳入标准的实验对象67例分为原发性无精子症组(A组)49例与原发性严重少精子症组(B组)18例,正常生育男性对照(C组)40例。确定了8个实验用序列标签位点(STS),分别是:sY84、sY86、sY127、sY134、sY152、sY153、sY254、sY255,并以X/Y连锁锌指蛋白基因(ZFX/Y)为内对照进行多重PCR筛查AZF微缺失。结果:67例实验组样本中,共检测出AZF微缺失8例,缺失率为11.94%,其中AZFc区缺失的有4例,AZFa+AZFc区缺失的有2例,AZFb+AZFc区缺失的有1例,AZFb区缺失的有1例。对照组未检出AZF基因微缺失。经χ2检验,实验组与对照组AZF区域STS总缺失率有显著性差异,实验组高于对照组。结论:Y染色体长臂AZF微缺失与原发性无精子症和严重少精子症相关,多重PCR是一种快速、有效的筛查方法。     

Y染色体微缺失与无精子症少精子症关系的研究

目的 探讨Y染色体微缺失与无精子症、少精子症的关系.方法 应用多重聚合酶链反应技术(PCR)对127例无精子症(80例)和严重少精子症(47例)的不育患者及60例正常生育男性进行Y染色体AZF基因、DAZ外显子检测.结果 无精子和严重少精子患者Y染色体微缺失7例,缺失率5.51%.其中AZFc缺失2例,DAZ外显子缺失5例.少精子症组缺失率8.51%,无精子症组缺失率3.75%,小睾丸组的缺失率6.54%,正常睾丸组缺失率4.94%,正常生育男性AZF基因和DAZ外显子均未检测到缺失.结论 (1)AZF因子、DAZ外显子微缺失可导致无精子症、严重少精子症:(2)绝大部分无精子、严重少精子患者Y染色体AZF因子、DAZ外显子并没有微缺失,有必要再去寻找新的精子发生基因.     

无精子及严重少精子症的遗传学缺陷分析

目的 探讨遗传缺陷在无精子、严重少精子症中的检测意义。方法 采用细胞遗传学技术及多重聚合酶链反应(PCR)技术对65例无精子及严重少精子症患者进行染色体核型分析、Y染色体无精子因子(AZF)检测，同时行精索输精管诊察，阴性者行精液果糖定量实验。结果 染色体核型异常8例(12．3％)，AZF因子缺失7例(10．8％)，输精管缺如2例(3.1％)。结论 遗传学检测在男性无精子、严重少精子症有重要意义。     

特发性无精子症和严重少精子症患者Y染色体基因微缺失研究

目的:研究Y染色体基因微缺失与特发性无精子症和严重少精子症的关系,及探讨Y染色体基因微缺失的位点、缺失率有无民族间的差异性.方法:应用多重实时荧光定量聚合酶链反应(PCR)法,对40例汉族及维吾尔族特发性无精子和严重少精子症患者进行Y染色体Azoospermia Factor(AZF)因子多位点的微缺失检测.结果:23例特发性无精子患者中,3例发生AZF因子缺失,缺失率为13.04%;17例严重少精子症患者中,2例发生AZF因子缺失,缺失率为11.76%.结论:Y染色体AZF因子微缺失的范围和位置对于胞质内体外受精治疗男性不育具有重要意义,但Y染色体AZF因子的缺失的位点及缺失率有无民族间的差异性,值得进一步研究.     

严重少精子症及非梗阻性无精子症患者Y染色体微缺失分析

目的探讨严重少精子症及非梗阻性无精子症与Y染色体长臂微缺失之间的关系。方法该病例对照研究包括216例严重少精子症、189例非梗阻性无精子症患者及100例精液参数正常的对照。采用多重PCR对Y染色体AZFa、AZFb、AZFc及AZFd区域进行检测。玷果在严重性少精子症患者中,AZF总缺失率为10．65％（23／216）,其中以AZFc区缺失最常见,占缺失的78．26％（18／23）;在非梗阻性无精子症患者中,AZF总缺失率为13．76％（26／189）,其中也以AZFc区缺失最常见,占缺失的57．69％（15／26）;在正常对照中发现1例AZFb缺失,两病例组AZF区缺失分别与对照组相比较均具有显著差异（X^2=9．066,P=0．003;X^2=10．74,P=0．001）。结论通过对Y染色体微缺失的检查可以从基因水平寻找生精障碍的原因以及为优生优育提供可靠的遗传信息依据。     

陕西地区不明原因无精子症和少精子症患者Y染色体长臂微缺失分析

目的: 评估陕西地区不明原因无精子症和少精子症不育男性患者Y染色体长臂微缺失的频率,探讨精子密度与Y染色体微缺失发生率的相关性。　方法: 以Y染色体特异性无精子症因子区STS AZFa、AZFb、AZFc和SRY4个基因 5个片段设计引物,采用PCR方法对 64例无精子症和少精子症患者以及 20例正常生育男性进行微缺失检测,并比较不同精子密度患者Y染色体微缺失的发生率。　结果: 20例精子密度正常的生育男性未检出Y染色体微缺失,而 64例特发性无精子症 /少精子症患者AZFc区的缺失率为17. 2% (11 /64),AZFc和AZFb联合缺失 1例,未发现AZFa区缺失,SRY基因均为阳性。其中无精子症组缺失率为21. 43% ( 3 /14 );精子密度 <1×106 /ml组,缺失率为 20. 0% (2 /10);精子密度 (1 ~5)×106 /ml组缺失率为17. 9% (5 /28);精子密度 (5 ~10 )×106 /ml组缺失率为8. 3% (1 /12)。各组缺失率经卡方检验差异有显著性 (χ2 =70. 144,P<0. 005 )。　结论: 无精子症和少精子症不育患者Y染色体AZFc缺失率明显较高,PCR扩增AZF基因是诊断Y染色体微缺失的简单方法。     

335例无精子症、严重少精子症患者细胞遗传学和分子遗传学检测

目的 从遗传学角度分析无精子症、严重少精子症的病因,为临床提供治疗和遗传咨询的依据.方法 对335例无精子症、严重少精子症患者采用外周血染色体核型分析和Y染色体AZF区域微缺失联合检测.结果 335例无精子症、严重少精子症患者中,染色体数目异常者29例,占总数8.66%;染色体结构异常6例,占总数1.79%;性反转1例占总数0.30%;AZF区域STS位点缺失6例,占总数1.79%;二项检测异常发生率为12.54%.结论 染色体核型分析和Y染色体微缺失是男性无精子症、严重少精子症重要的遗传检测指标.     

54例无精子症、少精子症患者Y染色体AZF微缺失的检测

目的 探讨Y染色体上AZF微缺失与男性无精子症及少精子症之间的关系。方法 采用多重PCR技术，对54例无精子症及少精子症患者AZF4个区的15个序列标签位点(STS)进行了微缺失检测，并同时做了细胞遗传学检查。结果 54例患者中共有4例发现微缺失(7．4％)，其中有2例在17例无精子症患者中发现(11．8％)，另2例在37例少精子症患者中发现(5．4％)。结论 AZF微缺失是导致男性无精子及少精子的重要原因之一，细胞遗传学检查与AZF微缺失无相关性。     

Molecular genetic analysis of microdeletion on AZF/DAZ gene in patients with idiopathic azoospermia and severe oligozoospermia in Fujian

Objective: To identify microdeletions in azoospermia factor(AZF) gene loci in patients with idiopathic azoospermia and severe oligozoospermia in Fujian. Methods: Molecular genetic detection method was used to detect microdeletion at the AZFa, AZFb, AZFc /DAZ,SRY region of Y chromosome in 47 azoospermia and 4 severe oligozoospermia patients. Genomic DNA was extracted from peripheral blood. The sequence tagged site (STS) primers tested in each cases were sY84(AZFa), sY 143(AZFb) sY254(AZFc).SRY region of Y chromosome for control. The PCR products were analyzed on a 2.0% agarose gel. Results: Microdeletions of the Y-chromosomal AZF loci were revealed in 18(35.3%,18/51) of 51 patients with idiopathic azoospermia and severe oligozoospermia. AZFa deletion was found in four (7.8%) patients, AZF b in five (9.8%) patients, AZF c in four (7.8%) patients. AZF a+b in one(1.9%)patient, AZF b+c in two (3.9%) patients, AZF a+b+c in two (3.9%)patients respectively. No deletion of SRY region was found. No deletion of AZF a, AZF b, AZF c/DAZ,SRY regions was found in five fertile male who had at least one or more children. Conclusions: Microdeletions on AZF/DAZ gene loci were major genetics defects leading to azoospermia and severe oligozoospermia in male idiopathic infertility in Fujian. It is necessary to have genetic counseling and carry out microdeletion detection on AZF/DAZ gene loci before performing intracytoplasmic sperm injection (ICSI).     

多重聚合酶链反应检测Y染色体无精子因子微缺失

目的:研究原发性无精、严重少精症与Y染色体无精子因子(AZF)微缺失之间的关系.方法:采用多重聚合酶链反应技术对103例原发无精子症、72例原发严重少精症患者及60例正常生育男性进行AZFa、AZFb、AZFc 3个区域微缺失分析.结果:60例正常生育男性未发现Y染色体AZF区域微缺失,175例生精障碍患者中发现AZF微缺失19例,总缺失率为10.9%.其中11例无精症患者和4例少精症患者的缺失发生在AZFc区域,缺失率为8.6%;1例无精症患者和2例少精症患者发生AZFb、AZFc双重缺失,缺失率为1.7%;1例无精症患者发生AZFa、b、c 3个区域同时微缺失,缺失率0.6%.生精障碍组与正常生育男性组比较Y染色体AZF区域微缺失率差异有统计学意义(P<0.01).结论:Y染色体AZF区域微缺失是引起男性无精、少精子症的重要原因之一.采用多重聚合酶链反应技术对原发无精、少精子症患者在单精子注射(ICSI)之前进行微缺失筛查是必要的.     

多重连接探针在无精子症和严重少精子症患者AZF微缺失检测中的应用

目的:探讨多重连接探针扩增技术(MLPA)在无精子症及严重少精子症不育男性无精子因子(AZF)微缺失筛查中的应用可能。方法:提取147例无精子症或严重少精子症患者及154例正常对照男性外周血DNA,经95℃变性后与设计合成的AZF区域探针特异杂交,杂交产物经连接酶连接后用带有FAM荧光标记的通用引物扩增,毛细管电泳将产物分离生成MLPA图谱。所有样本同时行AZF序列标签位点(STS)的多重PCR分析。结果:病例组STS缺失检出率为15.0%(22/147),对照组中未检出STS缺失者;MLPA法于病例组中检出40例AZF区探针缺失患者,检出率为27.2%,其中包括22例STS缺失型患者。对照组中亦有20例AZF探针缺失者。结论:相比较传统的多重PCR,MLPA技术在AZF微缺失筛查中具有更佳的检测灵敏度,同时MLPA图谱所展现的高分辨的AZF区遗传学信息将有助于男性生精障碍病因学机制的深入探索。     

新疆地区汉族维吾尔族不育症患者Y染色体长臂微缺失分析

目的评估新疆地区汉族、维吾尔族不明原因无精子症和严重少精子症男性患者Y染色体长臂微缺失的频率,探讨不同民族间Y染色体长臂微缺失发生率的差异。方法以Y染色体无精子因子(AZF)区STS- AZFa、AZFb、AZFc和AZFd 4个基因8片段设计引物,采用聚合酶链反应(PCR)方法对123例(汉族61例,维吾尔族62例)无精子症和少精予症不育男性患者进行Y染色体微缺失检测,并比较不同民族的患者Y染色体微缺失发生率的差异。结果61例汉族患者中有27例(44.26%)存在Y染色体微缺失,62例维吾尔族患者检出13例(20.97%)存在Y染色体微缺失,在所有被检出有Y染色体长臂微缺失的患者中AZF区联合缺失23例(58%)。汉族患者与维吾尔族患者Y染色体微缺失率及AZF多位点联合缺失发生率差异有统计学意义(P<0.05)。结论无精子症和严重少精子症不育男性患者中Y染色体长臂微缺失发生率及AZF多位点联合缺失发生率存在民族差异,PCR检测AZF基因是诊断Y染色体长臂微缺失的较好的方法。     

中国男性不育患者染色体核型及Y染色体微缺失分析

目的 探讨男性不育症与染色体畸变及Y染色体微缺失之间的关系.方法临床诊断男性不育患者1975例,采集外周血淋巴细胞常规培养,Giemsa染色,镜下观察并分析染色体核型;选取Y染色体特异性序列标签点(STS),应用PCR技术对无精子症及少精子症患者进行Y染色体微缺失检测.结果 1975例患者中,染色体核型异常305例(15.44%),其中常染色体异常101例(5.11%),患者主要表现为少精子症、畸形精子症;性染色体异常204例(10.33%),主要表现以克氏征(5.62%)为主.728例无精子症或少精子症患者中,Y染色体微缺失109例(14.97%),其中AZFa区缺失3例(2.75%),均表现为无精子症;AZFb区缺失5例(4.59%),表现为无精子症2例、严重少精子症2例,精液正常1例;AZFc区缺失者68例(62.39%),患者主要表现为无精子症和严重少精子症;AZFa区和AZFc区均缺失者5例(4.59%),均表现为无精子症;AZFb区和AZFc区均缺失者15例(13.76%),患者以无精子症表现为主;AZFa区、AZFb区和AZFc区均缺失者6例(5.50%),均表现为无精子症.结论染色体异常及Y染色体微缺失均为男性不育的重要病因.

Abstract：

Objective To study the relationship between chromosomal abnormality and Y chromosome microdeletions and male infertility. Methods Lymphocytes were cultured from peripheral blood of 1975 male infertility patients and stained with Giemsa. The chromosomes were analyzed under microscope. Y chromosome specific sequence tags (STS) were selected, then the Y chromosome microdeletions in AZF regions were screened by polymerase chain reaction (PCR) in azoospermia and oligozoospermia patients. Results There were 305 cases of detected chromosomal abnormalities (15.44%) in the 1975 cases. There were 101 cases (5.11 %) with autosome abnormalities which clinically manifested as oligozoospermia and teratospermia. There were 204 cases (10. 33%) of sexual chromosome abnormalities and the patients were mainly characterized with Klinefelter's syndrome. Y chromosome microdeletions were detected in 109 (14.97 %) of the 728 cases of azoospermia or oligozoospermia. The most common microdeletion of Y chromosome was AZFc (62.39%) and these patients were characterized with azoospermia and oligozoospermia. Five patients (4. 59%) who suffered Y chromosome microdeletion in AZFa region and AZFb region were characterized with azoospermia. Fifteen cases (13.76%) with microdeletion in AZFb region and AZFc region were mainly characterized with azoospermia. There were 6 cases (5. 50 % ) of microdeletion in AZFa, AZFb and AZFc regions,these patients were all characterized with azoospermia. Conclusions Both Chromosome abnormalities and Y chromosome microdeletions are important causes for male infertility.     

Natural transmission of AZFb Y-chromosomal microdeletion from father to his three sons

Microdeletions of the so-called azoospermia factor (AZF) locus of the Y chromosome long arm (Yq) are an etiological factor of severe oligozoospermia or azoospermia. Patients affected are infertile unless assisted reproductive techniques are used. We report the case of an azoospermic patient (proband) and three brothers who inherited a Yq microdeletion from their father through a spontaneous pregnancy. Leukocyte DNA was extracted using a commercially available kit. A total of 15 pairs of sequence-tagged site (STSs) based primers, spanning the AZFa, b and c regions, were used for screening. All brothers and their father carried a Yq microdeletion of the AZFb subregion where the RNA-binding motif (RBM) gene is located. The proband carried additional deletions of the AZFa and AZFb subregions. RBM deletion can be associated with oligozoospermia allowing natural conception and therefore natural transmission of this genetic anomaly.     

Detection of chromosomal abnormality and Y chromosome microdeletion in patients with azoospermia and oligozoospermia

Objective:To investigate the chromosomal abnormality and Y chromosome microdeletion in patients with azoospermia and oligozoospermia.Methods:Cytogenetic karyotype analysis and multiplex PCR were used to detect chromosomal abnormality and Y chromosome microdeletion in 99 azoospermic and 57 oligospermic patients(total 156).45 fertile men were includ-ed as controls.Results:31 patients were found with chromosomal abnormalities in 156 cases(31/156,19.9 %),20 cases showed 47,XXY,2 cases showed 46,XY/47,XXY,7 cases had Y chromosome structural abnormalities and 2 had autosomal chromosome abnormalities.There were significant differences between the frequency of AZF microde-letion in 125 cases with normal karyotype and 45 controls(P<0.01).The frequency of AZF microdeletion in 68 azoospermic and 57 oligospermic patients were 14.7%(10/68)and 15.8%(9/57)respectively,the difference was not significant(P>0.05).AZFa,AZFb,AZFa+b,AZFb+c,AZFa+b+d and AZFb+c+d mierodeletions were found in azoospermic patients.AZFb,AZFc,AZFd,AZFb+c+d and AZFc+d microdeletions were found in oligo-spermic patients.Conxlusion:The frequency of chromosomal abnormality was 19.9% and the frequency of Y chromosome mi-crodeletion was 15.2% in patient with azoospermia and oligozoospermia.We should pay close attention to this prob-lem.