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1.The Applicable Value of Serum Inhibin B in Distinguishing Obstructive and Non-obstructive Azoospermia 2.The Study of Y Chromosome Microdeletions in Patients with Non-obstructive Azoospermia

Author: CaiWenJuan
Tutor: GuZuoQun；YuHeMing；LiangXiaoZuo；LuWenHong
School: Peking Union Medical College , China
Course: Surgery
Keywords: Serum inhibin B Follicle stimulating hormone Seminal plasma neutral α- glucosidase Obstructive azoospermia Non-obstructive azoospermia Y chromosome microdeletions Male
CLC: R698.2
Type: Master's thesis
Year: 2010
Downloads: 90
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Abstract

At present, the clinical identification of OA and NOA sensitivity and specificity are very high serological markers. The the study serum INHB identify effect is imperative. INHB since been found so far, seventy years. In the the already completed INHB pilot study found its forecast of spermatogenesis in better condition, is a very potential clinical application of hormone. INHB purpose of the study is to predict the status of spermatogenesis in the testis, and thus provide the basis for clinical diagnosis and treatment of male infertility. However, inhibition of cytochalasin B in the normal reference range of domestic male as well as in the identification of OA and NOA value of these two issues has not been resolved. Significant due the serum INHB in different ethnic differences, so the normal reference range of foreign as well as identification of OA and NOA cut point can not be applied in the country. Although some domestic clinical research given the reference range, but are due to the insufficient specimen volume, and experimental methods behind and has not been widely adopted. FSH seminal plasma neutral α-Glu differences between patients with OA and NOA. In recent years, the growing body of evidence abroad more than FSH, INHB able to predict the occurrence of sperm. Study compared the the serum INHB and FSH, the sensitivity and specificity of the seminal plasma neutral α-Glu predict OA or NOA, can clarify the value of INHB in the identification of OA and NOA, which provide theoretical guidance for more scientific applications INHB of and experimental basis. Objective: This study by measuring serum inhibin B (INHB) and follicle stimulating hormone (FSH) and the classic indicators of seminal plasma neutral α-glucosidase (α-Glu), to evaluate INHB in the differential diagnosis of obstructive (OA ) and the value of non-obstructive azoospermia (NOA) and testicular sperm disorder occurs prejudging. Method healthy fertile men group (n = 60), testicular biopsy as the gold standard for determining the OA group (n = 39) (n = 77) and NOA group specimens from blood and semen samples for routine semen analysis, serum INHB, FSH and seminal plasma levels of neutral α-Glu, using receiver operating characteristic (ROC) curve method to determine the cut-off point and analyzed by calculating the area under the ROC curve, the sensitivity and specificity of the evaluation indexes. The results of the laboratory's healthy reproductive male serum INHB 95% reference range :20.37-206 .21pg/ml. Serum INHB FSH seminal plasma neutral α-Glu serum INHB / FSH ratio and INHB FSH joint between the OA group NOA group difference significant, statistically significant (P lt; 0.01). The area under the curve for serum INHB 0.985, the diagnostic value of the highest sensitivity 97.4%, specificity of 92.2%, cut point value 49.89pg/ml. Joint indicators conclusion the serum INHB than serum FSH, seminal plasma neutral α-Glu serum INHB / FSH ratio, or INHB FSH has the best sensitivity and specificity in the identification of OA and NOA. On the Y chromosome azoospermia factor gene locus (azoospermiafactor, AZF) microdeletions will result in non-obstructive azoospermia (non-obstructive azoospermia, NO A) the occurrence. Therefore, NOA patients with Y chromosome microdeletion to clarify the cause. Y chromosome microdeletions can be detected by PCR technology. Although some studies through a single weight or multiplex PCR technology research microdeletions of the Y chromosome of the male population from 2-22 sites, however, the detection technology and detection sites have been the subject of our argument. It has been found that the NOA patient populations occur Y chromosome microdeletions, deletion rates vary from 1% to 55%. Possible causes of differences in test results produce the following factors: (1) research object to select different standards; (2) detect the STSs mark-bit point density and location is different; (3) detection method; (4) groups, genetic background and environmental different. Objective: To evaluate multiple PCR and single-plex PCR detection of Y chromosome microdeletions pros and cons, the pros and cons of detected six sites and 15 sites analysis the NOA in patients with Y chromosome microdeletions prevalence. Through the the study patients Y chromosome microdeletions situation, a clear cause, provide guidance and experimental basis for clinical diagnosis and treatment of doctors. : 15 classic microdeletions sites were divided into six groups, to grope each group multiplex PCR reaction conditions; fumble 15 singlet primer PCR reaction conditions; then NOA patient DNA testing to determine each patients with Y chromosome microdeletions. Re-use of statistical methods for comparison of multiplex PCR and single-plex PCR; classic 15 microdeletions sites and traditional six microdeletion loci detection rate. Results: each group multiplex PCR reaction conditions. 73 patients after 6 microdeletion detection sites and 15 microdeletion detection sites found: both the number and sites of microdeletions missing the number compared with a statistically significant difference (χ 2 = 5.06, P lt; 0.05 and χ2 = 15.06, P lt; 0.05). Singlet PCR and multiplex PCR detection rate compared microdeletions number was not statistically significant (x3 = 2.25, P gt; 0.05) loci purpose differences statistically significant (χ 2 = 22.04, P < 0.05). In the 12 patients with NOA and the presence of the Y chromosome microdeletions, 1, 2, 3, 6 patients were missing 4,3,2,1 sites. Conclusion: The detection of microdeletions 15 sites found that 16.44% of the incidence of Y chromosome microdeletions NOA patients. 15 sites of Y chromosome microdeletions detection than six sites detected more clinical significance and value. Multiplex PCR detection of Y chromosome microdeletions lead to false negative results, single-plex PCR for confirmation. The study also found that the lack of AZFb c the spermatogenic functions injury may be more serious, Y chromosome microdeletions and testicular volume and different PCR instrument on the reaction conditions are not necessarily universal.

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CLC: > Medicine, health > Surgery > Urology ( urinary and reproductive system diseases) > Men 's sexual dysfunction > Male infertility
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