无精子症和严重少精子症患者AZF/DAZ基因微缺失的分子生物学检测

目的　用分子生物学方法检测无精子症和严重少精子症患者无精子基因 (AZF)AZF/DAZ基因微缺失。　方法　应用聚合酶链反应 (PCR)技术对无精子症 4 7例、严重少精子症 4例进行Y染色体AZFa、AZFb、AZFc/DAZ、SRY的微缺失检测。　结果　 5 1例患者缺失率为 35 .3% (18/ 5 1) ,其中AZFa、AZFb、AZFc的微缺失分别为 4例 (7.8% )、5例 (9.8% )和 4例 (7.8% )。无精子症患者 1例 (1.9% )为AZFa、AZFb的双重缺失 ,2例 (3.9% )为AZFb、AZFc的双重缺失 ;2例 (3.9% )为AZFa、AZFb和AZFc的三重缺失 ;5 1例SRY基因PCR扩增均为阳性。 5例已有生育的正常男性均无AZFa、AZFb、AZFc、SRY的微缺失。　结论　AZF/DAZ(包括AZFa、AZFb、AZFc/DAZ)基因的微缺失是引起无精子和严重少精子导致男性不育的重要原因之一。AZF/DAZ基因微缺失的分子生物学检测对不明原因的不育男性行胞浆内单精子注射 (ICSI)时有指导意义。     

Y染色体基因微缺失在严重少精子症和无精子症中的应用

目的 利用Y染色体基因微缺失的检测来明确少精子症、无精子症患者病因.方法 采用多重聚合酶链反应技术,针对31例严重少精子症和9例无精子症患者与对照组41名已正常生育的男性,进行AZFa、AZFb、AZFc、3个区域共12个序列标签位点(sequence tag site,STS)的微缺失分析.结果 严重少精子症31例中发现Y染色体微缺失6例,无精子症9例中发现Y染色体微缺失3例,而正常对照组41例均未发现Y染色体微缺失.此研究中发现缺失形式有2种,分别是AZFa+AZFb+AZFc区的全缺失和AZFc区的单独缺失.结论 Y染色体微缺失与精子发生障碍导致的不育有一定的联系.     

不育男性无精子症因子微缺失的分子与临床特征:5年研究回顾

目的:近年来,Y染色体长臂无精子症因子(AZF)微缺失与男性不育关系的研究已经取得了很大的进展。然而,AZF微缺失的形成机理及各种缺失类型与临床表型之间的关系还不十分确定。本研究的目的是探讨中国不育男性的Y染色体微缺失的发生率、缺失类型以及基因型与表型之间的关系。方法:本研究对2005年至2009年本院男科门诊502例非梗阻性无精子症和306例严重少精子症的不育男性进行Y染色体AZF缺失分析。结果:AZF总体缺失率为7.80%(63/808),其中无精子症不育男性缺失率为9.16%(46/502),严重少精症患者为5.56%(17/306)。完全的AZFa缺失或AZFb缺失患者的精液中均没有成熟精子,而AZFc缺失的表型是多样化的。1例部分AZFb缺失患者有成熟精子发生,精子密度呈轻度进行下降。最常见的缺失类型为AZFc b2/b4亚型,占60.32%(38/63),其中39.47%(15/38)的患者精液中能发现成熟精子,其中1例为自然遗传的AZFc b2/b4缺失。63例缺失患者中仅1例AZFc b2/b4缺失患者的精子密度超过2×109/L。结论:AZF微缺失对精子发生障碍具有良好的诊断和评估价值。对Y染色体微缺失的大样本临床研究有利于进一步明确基因型与表型的关系,更好地理解AZF缺失的机制。     

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.     

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.     

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。     

卵泡刺激素正常的无精子症患者无精子因子微缺失检测

研究表明，Yq11，23区域中多个基因片段即无精子因子（azoospermia factor，AZF）的缺失可导致无精子症和严重少精子症。我们选取与无精子症密切相关的Y染色体连锁的13个序列标记位点（sequence taged site，STS），分析无精子症患者Y染色体上AZFa、AZFb、AZFc、AZFd区微缺失情况，     

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。     

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。     

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。     

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).     

无精子症和严重少精子症患者Y染色体微缺失和基因缺失研究

目的研究中国特发性无精子症和少精子症患者Y染色体无精子症因子(AZF)区缺失和其中RBMY1A1、DAZ基因缺失。方法选取AZFa、b和c区6个序列标签位点(STS)对56例少精子症和33例无精子症患者进行外周血Y染色体微缺失分析,对缺失样本进行RBMY1A1和DAZ基因缺失分析。结果共确认6例患者发生Y染色体微缺失和基因缺失、占7%(6/89);其中5例AZFc/DAZ基因缺失,1例AZFb+c/RBMY1A1和DAZ基因缺失。结论AZF部分区域缺失的患者同时伴有与精子生成具有重要作用的基因缺失,并可能由此导致精子生成障碍。     

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.     

1052例Y染色体微缺失检测及14例微缺失家系调查

目的:通过对不育患者进行Y染色体微缺失筛查以及部分微缺失患者的家系追踪调查,探讨Y染色体微缺失父子间的自然垂直遗传特点。方法:对1 052例患者进行Y染色体无精子因子(AZF)检测,并对12例AZFc缺失患者,1例AZFb和1例AZFb+c缺失患者进行家系追踪调查,绘制AZF缺失患者男性直系家族成员男性不育家系系谱图。结果:1 052例患者,共发现Y染色体微缺失89例,其中AZFc缺失56例,AZFa缺失6例,AZFb缺失5例,AZFb+c缺失14例,AZFa+b+c缺失8例。在追踪调查的AZF缺失家系中,AZFb和AZFb+c仅先证者存在缺失,12例AZFc缺失患者中5例重度少精子症患者存在家族垂直遗传,另外1例重度少精子症患者和6例无精子症患者家系中除先证者有缺失外,其家系成员未发现缺失。结论:通过对Y染色体微缺失患者进一步的家系调查发现,仅重度少精子症的AZFc缺失患者可能由父亲垂直遗传而来,但与父系表型有差异。对AZF缺失的无精子症患者,无论何种缺失类型,由父亲垂直遗传而来的可能都不大。     

AZF microdeletions and partial deletions of AZFc region on the Y chromosome in Moroccan men

Aim： To evaluate for the first time the frequency of Y chromosome microdeletions and the occurrence of the partial deletions of AZFc region in Moroccan men, and to discuss the clinical significance of AZF deletions. Methods： We screened Y chromosome microdeletions and partial deletions of the AZFc region of a consecutive group of infertile men （n = 149） and controls （100 fertile men, 76 normospermic men）. AZFa, AZFb, AZFc and partial deletions of the AZFc region were analyzed by polymerase chain reaction （PCR） according to established protocols. Results： Among the 127 infertile men screened for microdeletion, four subjects were found to have microdeletions： two AZFc deletions and two AZFb＋AZFc deletions. All the deletions were found only in azoospermic subjects （4/48, 8.33%）. The overall AZFc deletion frequency was low （4/127, 3.15%）. AZF microdeletions were not observed in either oligoasthenoteratozoospermia （OATS） or the control. Partial deletions of AZFc （gr/gr） were observed in a total of 7 of the 149 infertile men （4.70%） and 7 partial AZFc deletions （gr/gr） were found in the control group （7/176, 3.98%）. In addition, two b2/b3 deletions were identified in two azoospermic subjects （2/149, 1.34%） but not in the control group. Conclusion： Our results suggest that the frequency of Y chromosome AZF microdeletions is elevated in individuals with severe spermatogenic failure and that gr/gr deletions are not associated with spermatogenic failure.     

男性不育患者Y染色体微缺失液态芯片筛查方法的建立及应用

目的建立一套全新的基因诊断方法,检测Y染色体无精子因子(azoospermia factor,AZF)区域微缺失,并对Y染色体微缺失与男性不育相关性进行初步探讨。方法按照欧洲男科协会和欧洲分子遗传实验质控网检测指南推荐标准,采用多重PCR-液态芯片技术对648例精子发生障碍的患者和100例合格捐精者进行Y染色体微缺失筛查。结果648例精子发生障碍的患者中,发现62例患者存在Y染色体AZF区域微缺失,对应于5种缺失模式AZFa,AZFb,AZFc,AZFb c,AZFa b c。按区域统计,AZFc区域缺失的频率最高,其次是AZFb,AZFa的检出率最低。无精子症患者中微缺失的发生率为12．31％,严重少精子患者中微缺失发生率为5．43％。100例对照组没有发现任何缺失,两组比较,差异显著(P<0．001)。结论男性不育与Y染色体微缺失密切相关,本研究建立的多重PCR方法-液态芯片技术平台,用于男性不育患者的YqAZF区域筛查,结果可靠、快捷、重复性好、通量高。     

Y chromosome deletions in azoospermic men in India

Genetic factors cause about 10% of male infertility. Azoospermia factors (AZFa, AZFb, AZFc) are considered to be the most important for spermatogenesis. We therefore made an attempt to evaluate the genetic cause of azoospermia, Y chromosome deletion in particular, in Indian men. We have analyzed a total of 570 men, including 340 azoospermic men and 230 normal control subjects. DNA samples were initially screened with 30 sequence-tagged site (STS) markers representing AZF regions (AZFa, AZFb, AZFc). Samples, with deletion in the above regions were mapped by STS walking. Further, the deletions were confirmed by Southern hybridization using the probes from both euchromatic and heterochromatic regions. Of the total 340 azoospermic men analyzed, 29 individuals (8.5%) showed Y chromosome deletion, of which deletion in AZFc region was the most common (82.8%) followed by AZFb (55.2%) and AZFa (24.1%). Microdeletions were observed in AZFa, whereas macrodeletions were observed in AZFb and AZFc regions. Deletion of heterochromatic and azoospermic regions was detected in 20.7% of the azoospermic men. In 7 azoospermic men, deletion was found in more than 8.0 Mb spanning AZFb and AZFc regions. Sequence analysis at the break points on the Y chromosome revealed the presence of L1, ERV, and other retroviral repeat elements. We also identified a approximately 240-kb region consisting of 125 bp tandem repeats predominantly comprised of ERV elements in the AZFb region. Histological study of the testicular tissue of the azoospermic men, who showed Y chromosome deletion, revealed complete absence of germ cells and presence of only Sertoli cells.