Eighty-two (82%) percent of the men from the couples with recurrent pregnancy loss as compared to 0% in the normally fertile males and 20% in the infertile males were found to have microdeletions in the AZFc region of the Y chromosome.

Editorial comment:
Firstly, it is important, as the authors note, that these are the results from a tertiary referral center and are unlikely to represent the true prevalence of y chromosome microdeletions in couples experiencing recurrent miscarriages. That being said, this is an important observation. The concept that genetic causes of male infertility are limited to abnormalities of sperm production (quantitatively) and not to qualitative abnormalities are not tenable. These findings do not only provide an explanation for recurrent miscarriage in a select population, but may have implications for couples utilizing testicular sperm acquisition and IVF/ICSI. This finding supports the "complete" genetic evaluation for patients entertaining the utilization of these technologies.

Sheri Dewan, Elizabeth E. Puscheck, Carolyn B. Coulam, Alexander J. Wilcox and Rajasingam S. Jeyendran

Fertility and Sterility, 85(2):441-44 February 2006

Written by Harris M. Nagler, MD, a Contributing Editor with UroToday.

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