Testiküler sperm ekstraksiyonu sonuçlarının AZF gen mutasyonları ile ilişkisi
Küçük Resim Yok
Tarih
2011
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Bu çalışmada azoospermik infertil erkek hastalarda yapılan testiküler sperm ekstraksiyonu (TESE) sonucunun Y mikrodelesyonu, karyotip analizi ve patoloji sonuçları ile ilişkisinin araştırılması amaçlanmıştır. Gereç ve yöntem: Ocak 2008-Aralık 2009 tarihleri arasında Ege Üniversitesi Tıp Fakültesi Üroloji Anabilim Dalı’nda TESE yapılan 165 infertil azoospermik erkek hasta medikal anamnez ve fizik muayene bulguları ile spermiogram, karyotip analizi, Y kromozomu mikrodelesyonu varlığı, FSH düzeyi ve TESE sonucunda sperm bulunabilirliği açısından değerlendirilmiştir. Bulgular: Olguların ortalama yaşı 34±5.42, infertilite süresi 73±57.7 ay ve infertilite tipi %98.8 primer olarak saptandı. Olguların ortalama testis hacmi 12.3 cc idi ve 32 hastada varikosel varlığı tespit edildi. Ortalama FSH düzeyi 17 IU/mL idi. Yedi (%4.2) hastanın karyotip analizinde Klinefelter sendromu (47XXY), 1 (%0.6) hastada 46XYinv(9)(p11;q13) inversiyonu, 1 (%0.6) hastada 46XXY(96)/46XY(3)/46XXXY(1) mozaikliği bulundu. Hastaların 10’unda AZFc, 1’inde AZFb ve 1 olguda her iki delesyona da rastlandı. Hastaların 109’una mikroTESE, 56 hastaya ise konvansiyonel TESE uygulandı. Patoloji sonuçlarına göre 91 (%55.2) olguda germ hücre aplazisi, 32 (%19.4) olguda maturasyon duraklaması, 23 (%13.9) olguda normal spermatogenez, 10 (%6.1) olguda tubüler skleroz, 9 (%5.5) olguda hipospermatogenez saptandı. Y mikrodelesyonu olan olguların %75’inde patoloji sonucu germ hücre aplazisi, %25’inde maturasyon duraklaması olarak saptandı. Tüm olguların %37.5’inde sperm bulunurken, bu oran AZFc mevcut olgularda %27.2 idi. Sonuç: TESE operasyonu, azospermi tedavisinde başarı ile uygulanabilen bir yöntemdir. AZF gen mutasyonunun saptanması olumsuz bir TESE sonucunu öngörmede faydalı bir analizdir.
Objective: in this study, the effects of testicular sperm extraction (TESE) outcome on Y microdeletion, caryotype analysis, and pathology results in azoospermic infertile male patients were investigated. Materials and methods: A total of 165 azoospermic infertile male patients who underwent TESE between January 2008-December 2009 in Ege University Faculty of Medicine, Urology Department have been evaluated for medical history, physical examination, spermiogram, caryotype analysis, Y chromosome microdeletion, FSH level, and TESE outcome regarding sperm availability. Results: Mean age of patients was 34±5.42 years, mean time of infertility was 73±57.7 months, and infertility type was primary in 98.8% of cases. Mean testicular volume was 12.3 cc, and varicocele was detected in 32 patients. Mean FSH level was 17 IU/mL. in 10 of the cases AZFc deletion, in 1 case AZFb deletion and in 1 case both deletions were identified. Number of patients underwent microTESE and conventional TESE were 109 and 56, respectively. Regarding the pathological outcomes, 91 (55.2%) cases were germinal cell aplasia, 32 (19.4%) cases were maturation arrest, 23 (13.9%) cases were normal spermatogenesis, 10 (6.1%) cases were tubulary sclerosis, 9 (5.5%) cases were hipospermatogenesis. the cases in which Y microdeletion was present, pathological outcome was 75% germinal cell aplasia and 25% maturation arrest. Sperm avaliability was present in 37.5% of all cases, and this ratio was 27.2% in the cases with AZFc mutation. Conclusion: TESE operation is a method that can be applied successfully in the treatment of azospermia. Detection of the AZF gene mutations is useful to predict a negative TESE outcome.
Objective: in this study, the effects of testicular sperm extraction (TESE) outcome on Y microdeletion, caryotype analysis, and pathology results in azoospermic infertile male patients were investigated. Materials and methods: A total of 165 azoospermic infertile male patients who underwent TESE between January 2008-December 2009 in Ege University Faculty of Medicine, Urology Department have been evaluated for medical history, physical examination, spermiogram, caryotype analysis, Y chromosome microdeletion, FSH level, and TESE outcome regarding sperm availability. Results: Mean age of patients was 34±5.42 years, mean time of infertility was 73±57.7 months, and infertility type was primary in 98.8% of cases. Mean testicular volume was 12.3 cc, and varicocele was detected in 32 patients. Mean FSH level was 17 IU/mL. in 10 of the cases AZFc deletion, in 1 case AZFb deletion and in 1 case both deletions were identified. Number of patients underwent microTESE and conventional TESE were 109 and 56, respectively. Regarding the pathological outcomes, 91 (55.2%) cases were germinal cell aplasia, 32 (19.4%) cases were maturation arrest, 23 (13.9%) cases were normal spermatogenesis, 10 (6.1%) cases were tubulary sclerosis, 9 (5.5%) cases were hipospermatogenesis. the cases in which Y microdeletion was present, pathological outcome was 75% germinal cell aplasia and 25% maturation arrest. Sperm avaliability was present in 37.5% of all cases, and this ratio was 27.2% in the cases with AZFc mutation. Conclusion: TESE operation is a method that can be applied successfully in the treatment of azospermia. Detection of the AZF gene mutations is useful to predict a negative TESE outcome.
Açıklama
Anahtar Kelimeler
Üroloji ve Nefroloji
Kaynak
Türk Üroloji Dergisi/Turkish Journal of Urology
WoS Q Değeri
Scopus Q Değeri
Cilt
37
Sayı
3
