Testicular sperm from patients with obstructive and nonobstructive azoospermia: aneuploidy risk and reproductive prognosis using testicular sperm from fertile donors as control samples.
OBJECTIVE
To establish a baseline incidence of chromosomal abnormalities in testicular sperm of fertile men and to determine the best control sample for comparisons with azoospermic males to estimate their reproductive prognosis.


METHODS
Prospective study.


METHODS
Infertility clinic.


METHODS
Sixteen obstructive azoospermic (OA) and 19 nonobstructive azoospermic patients (NOA). Control samples were ejaculated sperm from ten fertile donors and testicular sperm from ten other fertile donors.


METHODS
Fluorescence in situ hybridization (FISH) in sperm.


METHODS
Sperm numerical abnormalities for chromosomes 13, 18, 21, X, and Y; ongoing implantation and pregnancy rates in intracytoplasmic sperm injection (ICSI) cycles.


RESULTS
In control samples, testicular sperm showed higher incidences of diploidy (0.27% vs. 0.10%) and disomy for chromosomes 13 (0.16% vs. 0.07%), 21 (0.25% vs. 0.12%), and sex chromosomes (0.34% vs. 0.21%) than ejaculated sperm. Comparisons with ejaculated control samples showed 12.5% OA and 68.4% NOA patients having significantly higher incidence of sperm chromosomal abnormalities. Compared with testicular control subjects, fewer OA (6.3%) and NOA (42.1%) patients had chromosomally abnormal sperm. NOA patients had lower ongoing implantation and pregnancy rates than OA patients, particularly those with abnormal FISH compared with testicular control samples.


CONCLUSIONS
Sperm FISH analysis using testicular sperm control samples better identifies NOA patients with a lower likelihood of reproductive success.
Preimplantation Genetic Diagnosis Unit, Instituto Valenciano de Infertilidad, Valencia, Spain. lrodrigo@ivi.es
Lorena
L
Rodrigo
Carmen
C
Rubio
Vanessa
V
Peinado
Rafael
R
Villamón
Nasser
N
Al-Asmar
José
J
Remohí
Antonio
A
Pellicer
Carlos
C
Simón
Manuel
M
Gil-Salom
D000328:Adult; D000782:Aneuploidy; D053713:Azoospermia / Q000453:epidemiology / Q000235:genetics / Q000628:therapy; D004171:Diploidy; D005260:Female; D005298:Fertility; D006801:Humans; D017404:In Situ Hybridization, Fluorescence; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011247:Pregnancy; D018873:Pregnancy Rate; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D020554:Sperm Injections, Intracytoplasmic; D013094:Spermatozoa / Q000166:cytology*; D013737:Testis / Q000166:cytology*; D024182:Uniparental Disomy / Q000235:genetics