title: Success rate of microsurgical multiple testicular sperm extraction and sperm presence in the ejaculate in korean men with y chromosome microdeletions.
abstract: OBJECTIVE
  We assessed the frequency of azoospermia factor a (AZFa), AZFb, and AZFc deletions and examined correlations between the deletion sites and the success rates of sperm presence within the ejaculate and surgical sperm retrieval in Korean men.
  
  
  METHODS
  A total of 1,919 azoospermic and severely oligozoospermic men were assessed for Y chromosome microdeletions. Among them, 168 men with AZF deletions were identified and their medical records were reviewed.
  
  
  RESULTS
  Of the total 168 men with AZF deletions, there were 13 with AZFa, 10 with AZFb, 95 with AZFc, 37 with AZFbc, and 13 with AZFabc deletions. Of the 95 men with isolated AZFc deletion, 51 had the presence of sperm in the ejaculate. Of the infertile men with any other deletion, however, only two patients (one man with AZFb deletion and another with AZFbc deletion) showed the presence of sperm in the ejaculate. The success rates for surgical sperm retrieval were 7.1% (1/14) in men with AZFbc deletion and 54.8% (17/31) in the isolated AZFc deletion group. No sperm was obtained from the patients with AZFa or AZFb deletions who underwent microsurgical sperm retrieval. In the isolated AZFc deletion group, there were significant differences between azoospermic and severely oligozoospermic patients in terms of testicular volume and serum levels of follicle-stimulating hormone and luteinizing hormone, whereas no significant differences were found when the group was divided by surgical sperm retrieval outcomes.
  
  
  CONCLUSIONS
  Deletions of the AZFa and AZFb regions are associated with severe spermatogenetic impairment. However, more than half of men with an AZFc deletion had sperm within the ejaculate or testis for in vitro fertilization with intracytoplasmic sperm injection.
authors: Department of Urology, Cheil General Hospital & Women's Healthcare Center, Kwandong University College of Medicine, Seoul, Korea.
authors: Se Hwan
authors: SH
authors: Park
authors: Hyo Serk
authors: HS
authors: Lee
authors: Jin Ho
authors: JH
authors: Choe
authors: Joong Shik
authors: JS
authors: Lee
authors: Ju Tae
authors: JT
authors: Seo
keywords: Azoospermia; Infertility; Male; Y chromosome
references: J Assist Reprod Genet. 2012 Jun;29(6):539-46
references: 22456825
references: Hum Reprod. 1997 Nov;12(11):2422-8
references: 9436677
references: Fertil Steril. 2011 Jun 30;95(8):2439-48.e1-5
references: 21704208
references: Hum Genet. 1976 Oct 28;34(2):119-24
references: 1002136
references: Urology. 1997 Mar;49(3):435-40
references: 9123710
references: Hum Reprod Update. 2002 May-Jun;8(3):217-29
references: 12078833
references: Korean J Urol. 2013 Aug;54(8):536-40
references: 23956830
references: Hum Reprod. 2000 Jul;15(7):1431-4
references: 10875846
references: Hum Reprod. 2003 Aug;18(8):1660-5
references: 12871878
references: Hum Mol Genet. 1996 Jul;5(7):933-43
references: 8817327
references: Best Pract Res Clin Obstet Gynaecol. 2003 Apr;17(2):211-29
references: 12758096
references: Nat Genet. 1995 Aug;10(4):383-93
references: 7670487
references: Hum Reprod. 2002 Nov;17(11):2813-24
references: 12407032
references: Hum Reprod. 1991 Feb;6(2):245-50
references: 2056021
references: N Engl J Med. 1997 Feb 20;336(8):534-9
references: 9023089
references: Hum Reprod. 1998 Nov;13(11):3090-3
references: 9853862
references: Hum Reprod. 2005 Jul;20(7):1887-96
references: 15790609
references: Hum Reprod. 1999 Jan;14(1):33-8
references: 10374090
references: Mol Hum Reprod. 1997 Aug;3(8):699-704
references: 9294854
references: Lancet. 2004 Jul 17-23;364(9430):273-83
references: 15262106
references: Hum Reprod. 1997 Mar;12(3):503-8
references: 9130751
references: G Chir. 2004 Apr;25(4):117-20
references: 15283400
references: Hum Reprod. 1998 Feb;13(2):302-7
references: 9557827