The Prevalence of Y-chromosome Microdeletions in Oligozoospermic Men: A Systematic Review and Meta-analysis of European and North American Studies
| Autor: | R. Matthew Coward, Jaden R. Kohn, Ryan C. Owen, Taylor P. Kohn |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Male
endocrine system medicine.medical_specialty Y chromosome microdeletion Urology Sex Chromosome Disorders of Sex Development 030232 urology & nephrology Context (language use) Male infertility 03 medical and health sciences 0302 clinical medicine medicine Prevalence Humans Mass Screening Genetic Testing Patient summary reproductive and urinary physiology Infertility Male Sex Chromosome Aberrations Gynecology Chromosomes Human Y Sperm Count urogenital system business.industry Oligospermia medicine.disease Sperm Confidence interval Europe 030220 oncology & carcinogenesis Meta-analysis North America Chromosome Deletion business Evidence synthesis |
| Zdroj: | European urology. 76(5) |
| ISSN: | 1873-7560 |
| Popis: | European and North American guidelines recommend Y-chromosome microdeletion (YCM) screening in azoospermic and oligozoospermic men with sperm concentrations of5 million sperm/ml; however, numerous studies have suggested that YCMs are rare when sperm concentrations are1 million sperm/ml.We systematically reviewed and meta-analyzed European and North American studies to determine the prevalence of a complete YCM in oligozoospermic men with sperm concentrations of0-1,1-5, and5-20 million sperm/ml, and to determine whether 1 or 5 million sperm/ml is the most appropriate sperm concentration threshold for YCM screening.A systematic review of MEDLINE, EMBASE, Cochrane Library, and ClinicalTrials.gov was performed for studies assessing the prevalence of a complete YCM in oligozoospermic men in European and North American studies.Thirty-seven studies were identified during a systematic review (n = 12 492 oligozoospermic men). All complete YCMs in oligozoospermic men were AZFc microdeletions. Eighteen studies contained data conducive to meta-analysis (n = 10 866 men). Comparing the pooled estimated prevalence by sperm concentration, complete YCMs were significantly more common in men with sperm concentrations of0-1 million sperm/ml (5.0% [95% confidence interval {CI}: 3.6-6.8%]) versus1-5 million sperm/ml (0.8% [95% CI: 0.5-1.3%], p0.001). YCMs were similar in men with sperm concentrations of1-5 and5-20 million sperm/ml (0.8% [95% CI: 0.5-1.3%] vs 0.5% [95% CI: 0.2-0.9%], p = 0.14).In Europe and North America, the majority of YCMs occur in men with sperm concentrations of ≤1 million sperm/ml, with1% identified in men with1 million sperm/ml. Male infertility guidelines for North America and Europe should reconsider the sperm concentration screening thresholds to recommend testing for YCMs only for men with sperm concentrations of1 million sperm/ml.Complete Y-chromosome microdeletions (YCMs) are rare in men with1 million sperm/ml. Routine screening for YCMs should occur only if sperm concentration is ≤1 million sperm/ml. |
| Databáze: | OpenAIRE |
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