CAG Repeats in the androgen receptor gene is associated with oligozoospermia and teratozoospermia in infertile men in Jordan.

CAG trinucleotide repeats are coded for the polyglutamine tract in the N-terminal of the androgen receptor (AR) gene which varies in normal individuals from 6 to 36 residues. In this study, we inspected the impact of the CAG repeats on the spermatogenic defects by measuring the size of AR-CAG repeats length in a cohort of 260infertile and 169 fertile Jordanian men. The infertile group included three subgroups of a zoospermic, oligozoospermic and teratozoospermia men. The CAG allele size was determined by direct sequencing. The results showed a significant association between the length of the AR-CAG repeats and men's infertility (p = .001). In particular, the current cohort demonstrated a significant association between the AR-CAG length polymorphism and oligozoospermia (p < .001) and teratozoospermia (p < .001) but not azoospermia. According to distributions of allele frequency, the risk of oligozoospermia was 5.5-fold greater than normal when alleles frequency > 20 repeats, while the risk of teratozoospermia was > 10.6 folds greater than normal when allele frequency > 22 repeats. In conclusion, our results underscored that the long repeats of the AR-CAG polymorphism within the normal range might be associated with abnormal spermatogenesis such as teratozoospermia and oligozoospermia and contributing to infertility in Jordanian men.

4,977-bp human mitochondrial DNA deletion is associated with asthenozoospermic infertility in Jordan.

Male infertility is commonly associated with sperm abnormalities including asthenozoospermia. The molecular basis of asthenozoospermia was linked to mitochondrial DNA (mtDNA) mutations. The 4,977-bp human mtDNA deletion is one of the most common mutations of spermatozoa and results in loss of about 33% of the mitochondrial genome. In this preliminary study, we aimed to investigate the presence of 4,977-bp mtDNA deletion in asthenozoospermic infertile men in Jordan. Semen specimens of 120 asthenozoospermic infertile men and 80 normozoospermic individuals were collected at the in vitro fertilization unit. MtDNA was extracted after the enrichment of spermatozoa; then, polymerase chain reaction was performed using 4,977-bp mtDNA deletion-specific primers. The deletion of 4,977-bp mtDNA was detected in 79.2% of asthenozoospermic patients compared to 10% in normozoospermic controls. The results showed a significant association between the presence of 4,977-bp mtDNA deletion and the asthenozoospermia and infertility (OR = 34.2000, 95% CI = 14.57-80.26, p-value < .001). In conclusion, our findings underscored a strong association between 4,977-bp mtDNA deletion and asthenozoospermia in the Jordanian population.

The Incidence and Clinical Significance of Atypical Glandular Cells of Undetermined Significance on Cervical Pap Smears.

OBJECTIVE: To determine the incidence and the association between atypical glandular cells (AGC) reported on cervical pap smears and the underlying malignant and pre-malignant genital tract pathology. METHODS: A retrospective study was performed on the files of women who were had attended our colposcopy clinic at King Hussein Medical Centre (KHMC), between April 2014 and April 2018. Out of 8483 cervical pap smears reviewed, 68 patients have smears reported to be atypical glandular cells of undetermined significance (AGUS). Proper evaluation and follow up was available for 62 patients by performing colposcopic examination, repeating pap smear, proper biopsies and histological results. The factors considered included patients age, parity, symptoms, presence of pregnancy, smoking habits, hormonal therapy usage, colposcopic finding, and histological results of biopsies performed. Data were analyzed and comparison was performed between malignant and pre-malignant lesions. RESULTS: 68 cases of AGUS pap smears were identified out of 8483 cases reviewed forming incidence of about (0.8%). Of 62 patients with AGUS pap smears, twenty-two cases (32.3%) were found to have clinically significant malignant lesions on subsequent histological follow up. It included 12 cases of endometrial adenocarcinoma, 5 cases of adenocarcinoma of cervix, 3 cases of squamous cell carcinoma of cervix and 2 cases with secondary metastasis to vagina. Of the 62 patients with AGUS pap smears, fourteen cases (20.6%) were found to have pre-malignant lesions. This included 7 cases of endometrial hyperplasia, 3 cases of adenocarcinoma in situ of cervix (ACIS) and 4 cases with cervical squamous intra-epithelial lesions. Abnormal vaginal bleeding was the most common presenting symptom (30.6%); Woman above the age of 40 years and especially post-menopausal were more likely to have significant histological abnormalities. CONCLUSION: Though the incidence of AGUS is low, it still important and clinically significant due to high substantial risk of having underlying premalignant or malignant lesions. Colposcopy and directed biopsy, endo-cervical curettage and endometrial biopsy should be performed to all women with AGUC especially to those above the age of 40 years, menopause, or having abnormal vaginal bleeding.