Research On The Testical Pathology And AZF Microdeletion Of The Idiopathic Male Sterility

Objective: The severe oligozoospermia and idiopathic azoospermia in Chinese persons is a typical disease in male sterility, and the reason still remains obscure. Nowadays ICSI is considered a big breakthrough in the cure of male sterility, yet it has its disadvantages, that is ,the inherited defect may be passed down to the next generation, and lead to sterility again. Hence, the aim of this research is trying to track down the important relationship between seminal fluid of the patients who suffer from male sterility, testis pathology and AZF in clinical practice.Methods: 50 normal males, 100 males suffering sterility ( 50 has no sperm, 50 lack sperm ), one normal female. When their blood was PCR tested, the average sperm number for the normal males is >20×106/ml. The sterility males range from 28 to 42 in age, and their average sterility time is 5.8 years. To detect the role of azoospermia factors located on proximal Yq in spermatogenesis among Chinese patients with idiopathic azoospermia and oligozoospermia. voluntary subjects choose testicle biopsy. Eight sequence-tagged sites (STS) in azoospermia factor(AZF)and SRY regions of the Y chromosome were selected.Fifty azoospermia, Fifty oligozoospermia patiens and Fifty fertile men were evaluated using polymerase chain reaction technique(PCR).Results: Seventeen of 100 patiens(17%) with the AZFa ,AZFb or AZFc deletion were found,no deletion in the AZFd or SRY regions were found.No deletion was found in 50 fertile men ,however all the deletion was found in the women. Microdeletions in Yq is one of the risk facto rs to the Chinese patients with azoospermia or severe oligospermia; AZFa ,AZFb and AZFc gene may be minor to the spermatogenesis in some extent;for more microdeletions were found in the regions than in AZFd region,analysis of microdeletions should be focused on AZFa, AZFb and AZFc regions before the treatment of intracytoplasmic sperm injection(ICSI). There are some abnormal changes in the pathology of testicle accordingly.Conclusion: research on microdeletions of chromosome Y: (1) among the patients suffering AZFa, 75% of them only possess Sertoli's cells (sertoli cell-only syndrome,SCOS), 25% of them suffer lack of sperm seriously, who were generally treated with testicular spermaspiration,TESE to avoid injury, but were usually treated with genes,hence we can track down the cause of disease remove or introduce some genes accordingly. (2) patients suffering AZFb, who cannot form their sperms, are usually supposed to avoid TESE-ICSI way, but adopt other reproduction aids. (3) patients suffering AZFc are very in clinic practice. Their sperms can reach the required number but usually with abnormal formation. They can reproduce with other reproduction aids such freezing their sperms. Female are preferred in their reproduction to avoid inherit age defect.For the good condition of future generations, both the chromosome and testis pathology should be tested in treating patients suffering lack of sperms, especially before ICSI treatment. Further research will be done on the relationship between the three aspects ---male testis pathology, female habitual abortion, and lack of AZF. Further research should be carried out on the vaccine of curing no sperms or lack of sperms.