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摘要: 男性生殖遗传学异常包括染色体、基因、精子DNA完整性及表观遗传学等多个方面,是导致男性不育的重要病因。随着基因测序技术的进步和辅助生殖技术的广泛应用,男性生殖遗传学已成为近年来的研究热点。本文对近年的男性生殖遗传学临床研究进行了分析和总结。重点探讨了3种常见的男性生殖遗传学疾病:克氏综合征、Y染色体微缺失和先天性输精管缺如。克氏综合征的流行病学现状、临床表现、治疗方法、手术取精成功率等;Y染色体微缺失的流行病学现状、各种分型的临床表现和治疗方法,重点探讨了Y染色体AZFc区缺失的不同治疗方式及妊娠结局;先天性输精管缺如患者的CFTR基因突变情况,及其对生育的影响及治疗策略。指出了目前研究的不足,展望了未来研究的方向。Abstract: The abnormalities of male reproductive genetics include chromosomes, genes, sperm DNA integrity and epigenetics, which are important causes of male infertility. With the advancement of gene sequencing technology and the widespread application of assisted reproductive technology, male reproductive genetics has become a research hotspot in recent years. This article analyzes and summarizes the clinical research on male reproductive genetics in recent years. We mainly focus on three common male reproductive genetic diseases: Klinefelter syndrome, Y chromosome microdeletions and congenital absence of vas deferens. Epidemiological status, clinical manifestations, treatment methods of Klinefelter syndrome and sperm retrieval rate after surgery are discussed. Epidemiological status of Y chromosome microdeletions, the clinical manifestations and treatment of different types are also discussed, and the treatment and pregnancy outcomes of AZFc deletion are the main focuses. We discuss CFTR gene mutation in patients with congenital absence of vas deferens, its impacts on fertility and treatment as well. Finally, we point out the shortcomings of current researches, and look forward to the direction of future research.
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[1] Viuff MH,Stochholm K,Uldbjerg N,et al.Only a minority of sex chromosome abnormalities are detected by a national prenatal screening program for down syndrome[J].Hum Reprod,2015,30(10):2419-2426.
[2] Zhang M,Fan HT,Zheng HS,et al.Clinical characteristics of men with non-mosaic klinefelter syndrome in northeastern China:implications for genetic counseling[J].Gen Mol Res,2015,14(3):10897-10904.
[3] Chang S,Skakkebæk A,Trolle C,et al.Anthropometry in klinefelter syndrome--multifactorial influences due to cag length,testosterone treatment and possibly intrauterine hypogonadism[J].J Clin Endocrinol Metabol,2015,100(3):E508-E517.
[4] Corona G,Pizzocaro A,Lanfranco F,et al.Sperm recovery and icsi outcomes in klinefelter syndrome:A systematic review and meta-analysis[J].Hum Reprod Update,2017,23(3):265-275.
[5] Van Saen D,Vloeberghs V,Gies I,et al.When does germ cell loss and fibrosis occur in patients with klinefelter syndrome?[J].Hum Reprod,2018,33(6):1009-1022.
[6] Nahata L,Yu RN,Paltiel HJ,et al.Sperm retrieval in adolescents and young adults with klinefelter syndrome:A prospective,pilot study[J].J Pediatr,2016,170:260-265.e261-262.
[7] Franik S,Hoeijmakers Y,D'Hauwers K,et al.Klinefelter syndrome and fertility:Sperm preservation should not be offered to children with klinefelter syndrome[J].Hum Reprod,2016,31(9):1952-1959.
[8] Plotton I,Giscard d'Estaing S,Cuzin B,et al.Preliminary results of a prospective study of testicular sperm extraction in young versus adult patients with nonmosaic 47,xxy klinefelter syndrome[J].J Clin Endocrinol Metabol,2015,100(3):961-967.
[9] Eliveld J,van Wely M,Meiβner A,et al.The risk of tese-induced hypogonadism:A systematic review and meta-analysis[J].Hum Reprod Update,2018,24(4):442-454.
[10] Flannigan R,Patel P,Paduch DA.Klinefelter syndrome.The effects of early androgen therapy on competence and behavioral phenotype[J].Sex Med Rev,2018,6(4):595-606.
[11] Foland-Ross LC,Ross JL,Reiss AL.Androgen treatment effects on hippocampus structure in boys with klinefelter syndrome[J].Psychoneuroendocrinology,2019,100:223-228.
[12] Davis SM,Lahlou N,Cox-Martin M,et al.Oxandrolone treatment results in an increased risk of gonadarche in prepubertal boys with klinefelter syndrome[J].J Clin Endocrinol Metab,2018,103(9):3449-3455.
[13] Rohayem J,Nieschlag E,Zitzmann M,et al.Testicular function during puberty and young adulthood in patients with klinefelter's syndrome with and without spermatozoa in seminal fluid[J].Andrology,2016,4(6):1178-1186.
[14] Fu L,Xiong DK,Ding XP,et al.Genetic screening for chromosomal abnormalities and y chromosome microdeletions in chinese infertile men[J].J Assist Reprod Gen,2012,29(6):521-527.
[15] Krausz C,Hoefsloot L,Simoni M,et al.Eaa/emqn best practice guidelines for molecular diagnosis of y-chromosomal microdeletions:State-of-the-art 2013[J].Andrology,2014,2(1):5-19.
[16] Johnson M,Raheem A,De Luca F,et al.An analysis of the frequency of y-chromosome microdeletions and the determination of a threshold sperm concentration for genetic testing in infertile men[J].BJU Int,2019,123(2):367-372.
[17] Pan Y,Zhang HG,Xi QI,et al.Molecular microdeletion analysis of infertile men with karyotypic y chromosome abnormalities[J].J Intl Med Res,2018,46(1):307-315.
[18] Tang D,Liu W,Li G,et al.Normal fertility with deletion of sy84 and sy86 in AZFa region[J].Andrology,2020,8(2):332-336.
[19] Alksere B,Berzina D,Dudorova A,et al.Case of inherited partial azfa deletion without impact on male fertility[J].Case Rep Gen,2019,2019:3802613.
[20] Zhu XB,Gong YH,He J,et al.Multicentre study of y chromosome microdeletions in 1,808 chinese infertile males using multiplex and real-time polymerase chain reaction[J].Andrologia,2017,49(5).
[21] Franchim CS,Soares-Junior JM,Serafini PC,et al.Efficacy of mlpa for detection of y-chromosome microdeletions in infertile brazilian patients[J].J Assis Reprod Gen,2020,37(5):1251-1259.
[22] Liu X,Li Z,Su Z,et al.Novel y-chromosomal microdeletions associated with non-obstructive azoospermia uncovered by high throughput sequencing of sequence-tagged sites[J].Scien Rep,2016,6:21831.
[23] Schwarzer JU,Steinfatt H,Schleyer M,et al.Microdissection tese is superior to conventional tese in patients with nonobstructive azoospermia caused by y chromosome microdeletions[J].Andrologia,2016,48(4):402-405.
[24] Chen X,Ma Y,Zou S,et al.Comparison and outcomes of nonobstructive azoospermia patients with different etiology undergoing microtese and icsi treatments[J].Tran And Urol,2019,8(4):366-373.
[25] Zhang HL,Zhao LM,Mao JM,et al.Sperm retrieval rates and clinical outcomes for patients with different causes of azoospermia who undergo microdissection testicular sperm extraction-intracytoplasmic sperm injection[J].Asn J Androl,2020.
[26] Abur U,Gunes S,Asci R,et al.Chromosomal and y-chromosome microdeletion analysis in 1,300 infertile males and the fertility outcome of patients with AZFc microdeletions[J].Andrologia,2019,51(11):e13402.
[27] Corona G,Minhas S,Giwercman A,et al.Sperm recovery and icsi outcomes in men with non-obstructive azoospermia:A systematic review and meta-analysis[J].Hum Reprod Update,2019,25(6):733-757.
[28] Colaco S,Modi D.Consequences of y chromosome microdeletions beyond male infertility[J].J Assist Reprod Gen,2019,36(7):1329-1337.
[29] Xi Q,Zhang Z,Wang R,et al.Obstetric and perinatal outcomes of intracytoplasmic sperm injection for infertile men with y chromosome microdeletions[J].Medicine,2019,98(41):e17407.
[30] Miraghazadeh A,Sadighi Gilani MA,Reihani-Sabet F,et al.Detection of partial azfc microdeletions in azoospermic infertile men is not informative of microtese outcome[J].Intl J Fertil Steril,2019,12(4):298-302.
[31] Salvarci A,Gurbuz AS,Balasar M.Evaluation from a different perspective of 10-year results of infertile males with y chromosome AZFc microdeletions compared with a control group[J].Andrologia,2020,52(6):e13572.
[32] Verón GL,Tissera AD,Bello R,et al.Impact of age,clinical conditions,and lifestyle on routine semen parameters and sperm kinematics[J].Fertil Steril,2018,110(1):68-75.e64.
[33] Bieth E,Hamdi SM,Mieusset R.Genetics of the congenital absence of the vas deferens[J].Hum Gen,2020.
[34] de Souza DAS,Faucz FR,Pereira-Ferrari L,et al.Congenital bilateral absence of the vas deferens as an atypical form of cystic fibrosis:Reproductive implications and genetic counseling[J].Andrology,2018,6(1):127-135.
[35] Wang H,An M,Liu Y,et al.Genetic diagnosis and sperm retrieval outcomes for chinese patients with congenital bilateral absence of vas deferens[J].Andrology,2020,8(5):1064-1069.
[36] Yuan P,Liang ZK,Liang H,et al.Expanding the phenotypic and genetic spectrum of chinese patients with congenital absence of vas deferens bearing cftr and adgrg2 alleles[J].Andrology,2019,7(3):329-340.
[37] Patat O,Pagin A,Siegfried A,et al.Truncating mutations in the adhesion g protein-coupled receptor g2 gene adgrg2 cause an x-linked congenital bilateral absence of vas deferens[J].Am J Hum Gen,2016,99(2):437-442.
[38] Marson FAL,Bertuzzo CS,Ribeiro JD.Classification of cftr mutation classes[J].Lancet.Resp med,2016,4(8):e37-e38.
[39] Yang B,Wang X,Zhang W,et al.Compound heterozygous mutations in cftr causing cbavd in chinese pedigrees[J].Mol Gen Gen Med,2018,6(6):1097-1103.
[40] Lu S,Cui Y,Li X,et al.Association of cystic fibrosis transmembrane-conductance regulator gene mutation with negative outcome of intracytoplasmic sperm injection pregnancy in cases of congenital bilateral absence of vas deferens[J].Ferti Steril,2014,101(5):1255-1260.
[41] Wu H,Gao Y,Ma C,et al.A novel hemizygous loss-of-function mutation in adgrg2 causes male infertility with congenital bilateral absence of the vas deferens[J].J Assist Reprod Gen,2020.
[42] Eggers S,Sadedin S,van den Bergen JA,et al.Disorders of sex development:Insights from targeted gene sequencing of a large international patient cohort[J].Genome Biol,2016,17(1):243.
[43] Kar B,Sivamani S,Kundavi S,et al.Complete androgen insensitivity syndrome in three generations of indian pedigree[J].J Obst Gyn India,2016,66(Suppl 1):358-362.
[44] Xue LT,Wang RX,He B,et al.Effect of sperm DNA fragmentation on clinical outcomes for chinese couples undergoing in vitro fertilization or intracytoplasmic sperm injection[J].J Int Med Res,2016,44(6):1283-1291.
[45] Sun TC,Zhang Y,Li HT,et al.Sperm DNA fragmentation index,as measured by sperm chromatin dispersion,might not predict assisted reproductive outcome[J].Taiwan J Obstet Gynecol,2018,57(4):493-498.
[46] Cheung S,Parrella A,Rosenwaks Z,et al.Genetic and epigenetic profiling of the infertile male[J].PLoS One,2019,14(3):e0214275.
[47] Carrell DT.The sperm epigenome:Implications for assisted reproductive technologies[J].Adv Exp Med Biol,2019,1166:47-56.
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