ABSTRACT
Background: Y chromosome deletions [YCDs] in azoospermia factor [AZF] region are associated with abnormal spermatogenesis and may lead to azoospermia or severe oligozoospermia. Assisted reproductive tech- nologies [ART] by intracytoplasmic sperm injection [ICSI] and testicular sperm extraction [TESE] are commonly required for infertility management of patients carrying YCDs. The aim of this study was to estimate the frequency of YCDs, to find the most frequent variant in infertile men candidate for ART and to compare YCD distribution with a control fertile group. The semen parameters, hormonal profiles and ART outcomes of the infertile group were studied
Materials and Methods: This case-control study consisted of 97 oligozoospermic or non-obstructive azoospermic [NOA] infertile men, who had undergone ART, as the case group and 100 fertile men as the control group. DNA samples were extracted from blood samples taken from all 197 participants and YCDs were identified by multiplex polymerase chain reaction [PCR] of eight known sequence-tagged sites. The chi-square test was used to compare the mean values of hormone and sperm parameters between the two groups. P<0.05 was considered statistically significant
Results: No YCD was detected in the control group. However, 20 out of 97 [20.6%] infertile men had a YCD. AZFc, AZFbc and AZFabc deletions were detected in 15 [75%], four [20%] and one [5%] YCD-positive patients. No fertilization or clinical pregnancy was seen following ICSI in this sub-group with YCD. The mean level of FSH was significantly higher in the group with YCD [28.45 +/- 22.2 vs. 4.8 +/- 3.17 and 10.83 +/- 7.23 in YCD-negative patients with and without clinical pregnancy respectively]
Conclusion: YCD is frequent among NOA men and YCD screening before ART and patient counseling is thus strongly recommended
ABSTRACT
Our aim was to evaluate the value of serum prostate-specific antigen doubling time [PSADT] to differentiate patients with high-grade prostate cancer who require more aggressive therapy from those with low-grade cancer. Of 460 patients with extended 12-core transrectal ultrasonography-guided biopsy of the prostate, 59 with confirmed prostate cancer were selected. They had not received any previous treatment for prostate cancer and had at least 2 consecutive serum PSA tests with a rising trend. The PSADT was calculated in patients with 2 serum PSA levels measured with an interval more than 3 months. Of 59 patients with prostate cancer, 35 [59.3%] had low-grade and 24 [40.7%] had high-grade tumors. There was no difference in age between the two groups. The median PSADT in patients with high-grade tumors were 12.70 months [range, 0.7 to 44.8 months] and 25.00 months [range, 1.65 to 41.2 months; P=.001]. A total of 21 patients with high-grade tumors [87.5%] had a PSADT less than 12 months, while only 9 of those with low-grade tumors [25.7%] had a PSADT less than 12 months. A PSADT with low-grade tumors [25.7%] had a PSADT less than 12 months. A PSADT cutoff of 12 months provided a sensitivity of 74% and a specificity of 87% for differentiation of high-grade from low-grade cancers. We concluded that men with a short PSADT [<12 months] were at a higher risk of harboring a high-grade prostate cancer. Our data suggests PSADT can identify patients with high-grade tumors who require more aggressive therapy