Assisted reproductive technology and complex chromosomal rearrangements: the limits of ICSI |
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Authors: | Siffroi JP; Benzacken B; Straub B; Le Bourhis C; North MO; Curotti G; Bellec V; Alvarez S; Dadoune JP |
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Institution: | Laboratoire d'Histologie, Biologie de la Reproduction et Cytogenetique, Hopital Tenon, Paris, France. |
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Abstract: | Complex chromosomal rearrangements are very rare events in the human
population. According to our knowledge on the consequences of simple
reciprocal translocations for male fertility, translocations involving
three or more chromosomes are thought to lead to severe reproductive
impairments in terms of meiotic disturbance or chromosomal imbalance of
gametes. We report the case of a 48 year old man whose sperm count revealed
either oligozoospermia (<10(3) spermatozoa/ml) or azoospermia. He was
referred to the laboratory for in-vitro fertilization after
intracytoplasmic sperm injection. Cytogenetic investigations showed a
complex chromosomal rearrangement involving firstly a translocation between
the short arm of chromosome 7 and the long arm of chromosome 13 and
secondly a translocation between the short arm of the same chromosome 13
and the short arm of chromosome 9. Diagnosis was ascertained by
fluorescence in-situ hybridization and staining of the nucleolar organizer
regions. Theoretical study of the translocated chromosomes predicted a
'chain' configuration of the hexavalent at the pachytene stage of meiosis.
In all, 32 modes of segregation were considered and only one resulted
either in a normal or a balanced gamete karyotype. Genetic counselling and
choice of appropriate artificial reproduction technique are discussed.
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