We have studied a 43-year-old man with azoospermia. Chromosome analysis, using G-, Q-, and C-banding techniques, showed a dicentric 46,X,i(Yq) chromosome abnormality. The clinical, cytogenetic, endocrine, and testicular histologic findings are presented. The case is discussed in relation to the pertinent literature. This represents the first phenotypic male with this karyotype ever reported.
Key words: azoospermia, dicentric i(Yq) chromosome, gonadotropins, sex-determining genes, spermatogenesis
INTRODUCTIONThe human Y chromosome may show extreme length variability in normal individuals and in individuals with physical abnormalities [Cohen et al, 1966; McKenzie et al, 19721. These variations are due to differences in the length of the fluorescent and the nonfluorescent portion of the long arm of the Y chromosome [Tiepolo and Zuffardi, 1976; Verma et al, 19781. They are inherited in a Mendelian fashion [Bishop et al, 1962;de la Chapelle et al, 1963;Borgaonkar et al, 1969; McKenzie et al, 19721. A great number of different structural rearrangements of the Y chromosome has also been reported. These include deletions [Davis, 1981; Yunis et al, 19771, dicentrics [McIlree et al, 1966;Davis, 1981;Armendares et al, 1972;Cohen et al, 1973;Giraud et al, 1977; Schmid and D'Apuzzo, 19781, duplications [Sperling and Lackmann, 19711, inversions [Jacobs and Ross, 1966; Sparkes et al, 19701, isochromosomes [Jacobs and Ross 1966;Ferguson-Smith et al, 1969;Magnelli et al, 1974; Schmid and D'Apuzzo, 19781, rings [Chandley and Edmond, 1971; Steinbach et al, 19791, satellited Y chromosomes [Schmid, 1969; Turleau et al, 19781, and transloca- [Federman et al, 1967;Schmid, 1969;Biihler et al, 1971; Davis, 19811. These structural aberrations of the human Y chromosome may cause defective testicular histogenesis. The phenotype of persons with such abnormalities may vary from female with or without manifestations of the Ullrich-Turner syndrome to male with fertility [Federman et al, 1967; Chandley and Edmond, 1971; Davis, 19811. We present the clinical, cytogenetic, endocrine, and testicular histologic findings of an azoospermic man with a dicentric i(Yq) chromosome.
SUBJECT, METHODS, AND RESULTS
Case HistoryA 43-year-old man presented with primary infertility. He has a sister and three brothers who are fertile. He reported normal erection and ejaculation with adequate frequency of coitus. Semen analysis done on three seperate occasions showed azoospermia. He was 178 cm tall, had a span of 172 cm, and a weight of 82 kg. Body hair showed a normal male pattern except for decreased hair over the chest. There was no gynecomastia. Both testes were of normal size and consistency and his penis and urethra were normal. He was otherwise normal (Fig. 1).A testicular biopsy was done and part of the tissue was fixed in Bouin's solution for the histologic examination; the other part was directly transferred to an antibioticcontaining Hanks balanced salt solution for fibroblast culture.
Laboratory DataComplete blood count and urinalysis were no...