Original Article

Cytogenetic Investigation in a Group of Ten Infertile Men with Non-Obstructive Azoospermia: First Algerian 46, XX Syndrome

Abstract

Background: In Algeria, the data on infertility and its various causes are rare. Recently, the introduction of assisted reproduction has allowed expecting that 300000 couples, which represent 7% of couples of reproductive age, face difficulty conceiving a child. Knowing that most idiopathic cases are likely to be due to chromosomal abnormalities, we aimed to investigate genetic defects by karyotype analysis in Algerian infertile men, using peripheral blood lymphocytes.

Methods: A cytogenetic study was conducted on 10 men from infertile couples by Karyotype analysis of R-banding performed by lymphocyte culture technique. Fluorescence in situ hybridization was performed and molecular abnormalities were investigated by polymerase chain reaction. Follicle stimulating hormone (FSH) and luteinizing hormone (LH) levels were evaluated by immunoradiometric method.

Results: Chromosomal abnormalities were observed in 30% of the patients. We identified a homogenous Klinefelter syndrome patient with 47, XXY karyotype, a mosaic Klinefelter syndrome patient with 47, XXY/46, XY karyotype and a 46, XX male. Fluorescence in situ hybridization showed that the sex-determining region Y was translocated to the short arm of the X chromosome in patient with 46, XX chromosomal constitution and the presence of the SRY gene was confirmed by polymerase chain reaction and electrophoresis.

Conclusion: The occurrence of chromosomal abnormalities in 30% of the infertile men strongly supports the inclusion of routine cytogenetic testing for diagnostic establishment and suitable counseling for couples seeking for assisted reproduction technologies.

 

 

World Health Organization (1991). Infertility, a tabulation of available data on prevalence of pri-mary and secondary infertility. Publisher: Ge-neva World Health Organization, pp. 1-73.

Baïche L (2009). La procréation mé-dicalement as¬sistée en Algérie en chiffres : Une technique maîtrisée. Horizons, 15th Nov. Available from: http://www.djazairess.com/fr/horizons/3860

Chellat D, Rezgoune ML, Hamane D, Sem-mane O, Benlatrèche C, Abadi N, Satta D (2012). In¬fluence of methylenetetrahydro-folatereductase C677T gene polymor-phisms in Algerian infer¬tile men with azo-ospermia or severe oligozoo¬spermia. Genet Test Mol Biomarkers, 16(8): 874-8.

Chellat D, Rezgoune ML, McElreavey K, Kherou¬atou N, Benbouhadja S, Douadi H, Cherifa B, Abadi N, Satta D (2013). First study of mi¬crodeletions in the Y chromo-some of Algerian infertile men with idio-pathic oligo-or azoo¬spermia. Urol Int, 90(4): 455-9.

Campagne DM (2013). Can Male Fertility Be Im¬proved Prior to Assisted Reproduction through The Control of Uncommonly Considered Fac¬tors? Int J Fertil Steril, 6(4): 214-23.

Ferlin A, Arredi B, Foresta C (2006). Genetic causes of male infertility. Reprod Toxicol, 22(2): 133-41.

Huyghe E, Izard V, Rigot JM, Pariente JL, Tostain J (2008).Optimal evaluation of the infertile male. 2007, French urological as-sociation guidelines. Prog Urol, 18(2): 95-101.

World Medical Association (2013). Declara-tion of Hel¬sinki, Ethical Principles for Medical Research Involving Human Sub-jects. JAMA, 310 (20): 2191-4.

Shaffer LG, McGowan-Jordan J, Schmid M (2013). An International System for Human Cy-togenetic Nomencla¬ture. 1st ed. S. Karger pub-lishers, Basel, pp. 1-140.

Van Assche E, Bonduelle M, Tournaye H, Joris H, Verheyen G, Devroey P, Van Steirteghem A, Liebaers I (1996). Cytoge-netics of infertile men. Hum Reprod, 11 (Suppl 4):1-24.

Visootsak J, Graham JM Jr (2006). Klinefelter syndrome and other sex chromosomal aneuploidies. Orphanet J Rare Dis, 1: 42.

Elfateh F, Wang R, Zhang Z, Jiang Y, Chen S, Liu R (2014). Influence of genetic ab-normalities on semen qual¬ity and male fer-tility: four-year prospective study. Iran J Re-prod Med, 12(2): 95-102.

Greco E, Scarselli F, Minasi MG, Casciani V, Zavaglia D, Dente D, Tesarik J, Franco G (2013). Birth of 16 healthy children after ICSI in cases of nonmosaicKline¬felter syndrome. Hum Reprod, 28(5): 1155-60.

Samplaski MK, Lo KC, Grober ED, Millar A, Dimi¬tromanolakis A, Jarvi K A (2014). Phenotypic differ¬ences in mosaic Kline-felter patients as compared with non-mosaic Klinefelter patients. Fertil Steril, 101(4): 950-5.

Wang T, Liu JH, Yang J, Chen J, Ye ZQ (2009). 46, XX male sex reversal syn-drome: a case report and review of the genetic basis. Andrologia, 41(1): 59-62.

Méndez JP, Ulloa-Aguirre A, Kofman-Alfaro S, Canto P, Reyes E, Diaz-Cueto L, Pérez-Pala¬cios G (1996). Phenotypical expression in XX males correlates with testicular re-sponse to ex¬ogenous choriogonadotropin in early infancy: does a variable degree of testicular failure deter¬mine the degree of genital ambiguity? Arch An¬drol, 37(1): 19-26.

Li JH, Huang TH, Jiang XW, Xie QD (2004). 46, XX male sex reversal syn-drome. Asian J Androl, 6(2): 165-7.

De la Chapelle A, Hortling H, Niemi M, Wennstroem J (1964). XX sex chromo-somes in a human male: first case. Acta Med Scand, 175(suppl 412): 25-8.

Wu CJ, Song YM, Sheu WH (1999). Short stature in a 46, XX male adolescent. South Med J, 92(9): 921-3.

Xia XY, Cui YX, Lu HY, Yang B, Wang GH, Pan LJ, Hou BS, Ge YF, Shao Y, Yao B, Huang YF (2007). Clinical, molecular and cytogenetic stud¬ies on 4 patients with 46, XX (SRY positive) male syndrome. Zhong-hua Nan Ke Xue, 13(12): 1094-7.

Yamamoto M, Yokoi K, Katsuno S, Hibi H, Miyake K (1995). A case of sex reversal syndrome with sex-deter¬mining region (XX male). Nagoya J Med Sci, 58(3-4): 111-5.

Tomomasa H, Adachi Y, Iwabuchi M, To-hyama Y, Yotsukura M, Oshio S, Yazaki T, Umeda T, Takano T, Yamanouchi Y, Nakahori Y (1999). XX-male syndrome bearing the sex-determining region Y. Arch Androl, 42(2): 89-96.

Yencilek F, Baykal C (2005). 46 XX male syndrome: a case report. Clin Exp Obstet Gynecol, 32(4): 263-4.

Gunes S, Asci R, Okten G, Atac F, Onat OE, Ogur G, Aydin O, Ozcelik T, Bagci H (2013). Two males with SRY-positive 46, XX testicular disorder of sex develop-ment. Syst Biol Reprod Med, 59(1): 42-7.

Pepene CE, Coman I, Mihu D, Militaru M, Duncea I (2008). Infertility in a new 46, XX male with positive SRY confirmed by fluorescence in situ hybridization: a case report. Clin Exp Obstet Gynecol, 35(4): 299-300.

Pastor Guzmán JM, Pastor Navaro H, Quin-tanilla Mata ML, CarriónLópez P, Mar-tínezRuíz J, Mar¬tínezSanchiz C,PeránTeruel M, Virseda Rodríguez JA (2011). 46,XX testicular disorder of sex develop¬ment. Case report. Arch Esp Urol, 64(5): 468-73.

Ahsan T, Saleem M, Ahmed A, Muzaffar M (1998). 46 XX male: a case of sex reversal syndrome. J Pak Med Assoc, 48(1): 19-20.

López M, Torres L, Méndez JP, Cervantes A, Al¬faro G, Pérez-Palacios G, Erickson RP, Kof¬man-Alfaro S (1995). SRY alone can induce normal male sexual differentiation. Am J Med Genet, 55(3): 356-8.

Ahmad A, Siddiqui MA, Goyal A, Wangnoo SK (2012). Is 46XX karyotype always a female? BMJ Case Rep, 2012. pii: bcr2012006223

Mohammed F, Al-Yatama F, Al-Bader M, Tayel SM, Gouda S, Naguib KK (2007). Primary male infertility in Kuwait: a cyto-genetic and molecular study of 289 in¬fertile Kuwaiti patients. Andrologia, 39(3): 87-92.

Bouayad Abdelmoula N, Portnoi MF, Kesles L, Recan D, Bahloul A, Boudawara T, Saad A, Rebai T (2003). Skewed S-chromosome inactivation pattern in SRY positive XX maleness: a case report and review of literature. Ann Genet, 46(1): 11-8.

Jain M, VeeraMohan V, Chaudhary I, Halder A (2013). The Sertoli Cell Only Syndrome and Glaucoma in a Sex-Determining Re-gion Y (SRY) Positive XX Infertile Male. J Clin Diagn Res, 7(7) : 1457-9.

Reddy PP, Papenhausen PR, Suh YM, Rid-dick LM, Cal¬vano CJ, Mandell J (1997). XX sex reversal: molecular analysis of the SRY/ZFY regions. J Urol, 158 (3 Pt 2): 1305-7.

Schiebel K, Winkelmann M, Mertz A, Xu X, Page DC, Weil D, Petit C, Rappold GA (1997). Abnormal XY interchange be-tween a novel isolated protein kinase gene, PRKY, and its homologue, PRKX, ac-counts for one third of all (Y+)XX males and (Y-)XY females. Hum Mol Genet, 6(11): 1985-9.

Plöchl E, Vlasak I, Rittinger O, Bergendi E, Stopar M, Kurnik P, Nachtigall M, Zierler H, Rappold GA, Schiebel K (1999). Clini-cal, cytogenetic and molec¬ular analysis of three 46,XX males. J Pediatr Endo¬crinol Metab, 12(3): 389-95.

Onrat ST, Söylemez Z, Elmas M (2012). 46,XX, der(15),t(Y ;15)(q12 ;p11) karyo-type in an azoosper¬mic male. Indian J Hum Genet, 18(2): 241-5.

Hawkins JR, Koopman P, Berta P (1991). Testis-deter¬mining factor and Y-linked sex reversal. Curr Opin Genet Dev, 1(1): 30-3.

Xiao B, Ji X, Xing Y, Chen Y, Tao J (2013). A rare case of 46, XX SRY- negative male with a w74-kb dupli¬cation in a region up-stream of SOX9. Eur J Med Genet, 56(12): 695-8.

Kolon TF, Ferrer FA, McKenna PH (1998). Clinical and molecular analysis of XX sex reversed patients. J Urol, 160(3 Pt 2): 1169-72.

Chiang HS, Wu YN, Wu CC, Hwang JL (2013). Cy¬togenic and molecular analyses of 46, XX male syn¬drome with clinical comparison to other groups with tes¬ticular azoospermia of genetic origin. J Formos Med As¬soc, 112(2): 72-8.

De la Chapelle A, Hästbacka J, Korhonen T, Mäenpää J (1990). The etiology of XX sex reversal. Reprod Nutr Dev, (Suppl 1): 39s-49s.

Wang XQ, Zhang HY, Qi QW, Zhao J, Xu L (2011). Relationship between follicle stimulat¬ing hormone and AZF microdele-tion on Y chromosome in patients with Azoospermia or severe Oligozoospermia. Zhonghua Yi Xue Yi Chuan Xue Za Zhi, 28: 559-61.

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IssueVol 45 No 6 (2016) QRcode
SectionOriginal Article(s)
Keywords
Male infertility Cytogenetic Azoospermia Severe oligozoospermia

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How to Cite
1.
BAZIZ M, HAMOULI-SAID Z, RATBI I, HABEL M, GUAOUA S, SBITI A, SEFIANI A. Cytogenetic Investigation in a Group of Ten Infertile Men with Non-Obstructive Azoospermia: First Algerian 46, XX Syndrome. Iran J Public Health. 2016;45(6):739-747.