Contributions to Rare Phenotypes in Klinefelter Syndrome
Year 2025,
Volume: 9 Issue: 1, 58 - 65, 31.01.2025
Yunus Arıkan
,
Ünal Öztekin
Abstract
Purpose: Klinefelter Syndrome (47, XXY) and Y chromosome microdeletions are the most common causes of male infertility. We aimed to evaluate the most common genetic and non-genetic factors that causes male infertility in our region.
Material and Methods: In this current study, 58 patients diagnosed with azoospermia/oligozoospermia were invited to the polyclinic and 2 ml peripheral blood samples were collected. Genotyping was performed following the isolation of genomic DNA from peripheral blood samples of patients who accepted to participate in our study.
Results: We found that high follicle stimulating hormone (FSH) value can be used as a predictive factor in azoospermia. We successfully revealed the potential of Klinefelter Syndrome (3.2%) but no Y chromosome microdeletions are responsible for primary male infertility. A patient with KS that having not only short height but also not-enlarged breasts were detected.
Conclusion: Physicians must be aware of unexpected features such as short stature may accompanied to KS in adult patients with untreated growth hormone. Non-genetic factors such as varicocele (28%) and smoking (28%) may have more potentials to explain primary infertility in our region.
Ethical Statement
KAEK-189_2019.09.25_20
Supporting Institution
Yozgat Bozok University Scientific Research Projects Unit.
Project Number
6602c-TF/19-333
References
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- Ghorbel M, Baklouti-Gargouri S, Keskes R, Chakroun N, Sellami A, Fakhfakh F, et al. Deletion of CDY1b copy of Y chromosome CDY1 gene is a risk factor of male infertility in Tunisian men. Gene 2014;548(2):251–5.
- Jungwirth A, Giwercman A, Tournaye H, Diemer T, Kopa Z, Dohle G, et al. European Association of Urology Guidelines on Male Infertility: The 2012 Update. Eur Urol 2012;62(2):324–32.
- Klinefelter HF, Reifenstein EC, Albright F. Syndrome Characterized by Gynecomastia, Aspermatogenesis without A-Leydigism, and Increased Excretion of Follicle-Stimulating Hormone1. J Clin Endocrinol Metab 1942;2(11):615–27.
- Visootsak J, Graham JM. Klinefelter syndrome and other sex chromosomal aneuploidies. Orphanet J Rare Dis. 2006;1(1):42.
- Johnson MD. Genetic risks of intracytoplasmic sperm injection in the treatment of male infertility: recommendations for genetic counseling and screening. Fertil Steril 1998;70(3):397–411.
- Esteves SC, Agarwal A. Novel concepts in male infertility. Int braz j urol. 2011;37(1):5–15.
- Gallego A, Rogel R, Luján S, Plaza B, Delgado F, Boronat F. Microdeleciones del gen AZF: serie de casos y revisión de la literatura. Actas Urológicas Españolas 2014;38(10):698–702.
- Gonçalves C, Cunha M, Rocha E, Fernandes S, Silva J, Ferraz L, et al. Y-chromosome microdeletions in nonobstructive azoospermia and severe oligozoospermia. Asian J Androl 2017;19(3):338.
- Mau-Holzmann UA. Somatic chromosomal abnormalities in infertile men and women. Cytogenet Genome Res 2005;111(3–4):317–36.
- Tiepolo L, Zuffardi O. Localization of factors controlling spermatogenesis in the nonfluorescent portion of the human y chromosome long arm. Hum Genet 1976;34(2):119–24.
- Lahn BT, Pearson NM, Jegalian K. The human Y chromosome, in the light of evolution. Nat Rev Genet 2001;2(3):207–16.
- Foresta C, Ferlin A, Garolla A, Moro E, Pistorello M, Barbaux S, et al. High frequency of well-defined Y-chromosome deletions in idiopathic Sertoli cell-only syndrome. Hum Reprod 1998;13(2):302–7.
- Blagosklonova O. AZFa deletions in Sertoli cell-only syndrome: a retrospective study. Mol Hum Reprod 2000;6(9):795–9.
- Kamp C. High deletion frequency of the complete AZFa sequence in men with Sertoli-cell-only syndrome. Mol Hum Reprod 2001;7(10):987–94.
- Li LL, Zhu YZ, Yu XW, Wang RX, Hu ZM, Liu RZ. Pedigrees of infertile Chinese men with Y chromosome microdeletions derived from natural transmission and de novo mutation. Genet Mol Res 2015;14(1):1932–41.
- Vogt PH. AZF deletions and Y chromosomal haplogroups: history and update based on sequence. Hum Reprod Update 2005;11(4):319–36.
- Kichine E, Rozé V, Di Cristofaro J, Taulier D, Navarro A, Streichemberger E, et al. HSFY genes and the P4 palindrome in the AZFb interval of the human Y chromosome are not required for spermatocyte maturation. Hum Reprod 2012;27(2):615–24.
- Alechine E, Corach D. High-Throughput Screening for Spermatogenesis Candidate Genes in the AZFc Region of the Y Chromosome by Multiplex Real Time PCR Followed by High Resolution Melting Analysis. PLoS One 2014;9(5):e97227.
- Jobling M. Recurrent duplication and deletion polymorphisms on the long arm of the Y chromosome in normal males. Hum Mol Genet 1996;5(11):1767–75.
- Singer ST, Killilea D, Suh JH, Wang ZJ, Yuan Q, Ivani K, et al. Fertility in transfusion-dependent thalassemia men: effects of iron burden on the reproductive axis. Am J Hematol 2015;90(9):E190-2.
- Nakamura Y, Kitamura M, Nishimura K, Koga M, Kondoh N, Takeyama M, et al. Chromosomal variants among 1790 infertile men. Int J Urol. 2001 Feb;8(2):49–52.
- Bojesen A, Juul S, Gravholt CH. Prenatal and Postnatal Prevalence of Klinefelter Syndrome: A National Registry Study. J Clin Endocrinol Metab 2003;88(2):622–6.
- Danacıoglu YO, Yenice MG, Akkas F, Soytas M, Seyhan S, Tasci Aİ. The genetic causes of infertility in patients with oligozoospermia and azoospermia in Turkish population. Yeni Üroloji Derg 2021;16(16–2):159–64.
- Rossodivita A, Colabucci F. Short stature in a patient with Klinefelter syndrome and growth hormone deficiency. Am J Med Genet 1994;49(2):244–6.
- Ramesh J, Nagasatyavani M, Venkateswarlu J, Nagender J. An Unusual Combination of Klinefelter Syndrome and Growth Hormone Deficiency in a Prepubertal Child. J Clin Res Pediatr Endocrinol 2014;187–9.
- Sanz Marcos N, Turón Viñas A, Ibáñez Toda L. Síndrome de Klinefelter de presentación atípica. An Pediatría 2013;79(2):112–5.
- Fang H, Xu J, Wu H, Fan H, Zhong L. Combination of Klinefelter Syndrome and Acromegaly: A Rare Case Report. Medicine (Baltimore) 2016;95(17):e3444.
- Colaco S, Modi D. Genetics of the human Y chromosome and its association with male infertility. Reprod Biol Endocrinol 2018;16(1):14.
- Balkan M, Tekes S, Gedik A. Cytogenetic and Y chromosome microdeletion screening studies in infertile males with Oligozoospermia and Azoospermia in Southeast Turkey. J Assist Reprod Genet 2008;25(11–12):559–65.
- Mirfakhraie R, Mirzajani F, Kalantar SM, Montazeri M, Salsabili N, Pourmand GR, et al. High prevalence of AZFb microdeletion in Iranian patients with idiopathic non-obstructive azoospermia. Indian J Med Res 2010;132:265–70.
- Oud MS, Houston BJ, Volozonoka L, Mastrorosa FK, Holt GS, Alobaidi BKS, et al. Exome sequencing reveals variants in known and novel candidate genes for severe sperm motility disorders. Hum Reprod 2021;36(9):2597–611.
Contributions to Rare Phenotypes in Klinefelter Syndrome
Year 2025,
Volume: 9 Issue: 1, 58 - 65, 31.01.2025
Yunus Arıkan
,
Ünal Öztekin
Project Number
6602c-TF/19-333
References
- Zegers-Hochschild F, Adamson GD, de Mouzon J, Ishihara O, Mansour R, Nygren K, et al. The International Committee for Monitoring Assisted Reproductive Technology (ICMART) and the World Health Organization (WHO) Revised Glossary on ART Terminology, 2009. Hum Reprod 2009;24(11):2683–7.
- Ghorbel M, Baklouti-Gargouri S, Keskes R, Chakroun N, Sellami A, Fakhfakh F, et al. Deletion of CDY1b copy of Y chromosome CDY1 gene is a risk factor of male infertility in Tunisian men. Gene 2014;548(2):251–5.
- Jungwirth A, Giwercman A, Tournaye H, Diemer T, Kopa Z, Dohle G, et al. European Association of Urology Guidelines on Male Infertility: The 2012 Update. Eur Urol 2012;62(2):324–32.
- Klinefelter HF, Reifenstein EC, Albright F. Syndrome Characterized by Gynecomastia, Aspermatogenesis without A-Leydigism, and Increased Excretion of Follicle-Stimulating Hormone1. J Clin Endocrinol Metab 1942;2(11):615–27.
- Visootsak J, Graham JM. Klinefelter syndrome and other sex chromosomal aneuploidies. Orphanet J Rare Dis. 2006;1(1):42.
- Johnson MD. Genetic risks of intracytoplasmic sperm injection in the treatment of male infertility: recommendations for genetic counseling and screening. Fertil Steril 1998;70(3):397–411.
- Esteves SC, Agarwal A. Novel concepts in male infertility. Int braz j urol. 2011;37(1):5–15.
- Gallego A, Rogel R, Luján S, Plaza B, Delgado F, Boronat F. Microdeleciones del gen AZF: serie de casos y revisión de la literatura. Actas Urológicas Españolas 2014;38(10):698–702.
- Gonçalves C, Cunha M, Rocha E, Fernandes S, Silva J, Ferraz L, et al. Y-chromosome microdeletions in nonobstructive azoospermia and severe oligozoospermia. Asian J Androl 2017;19(3):338.
- Mau-Holzmann UA. Somatic chromosomal abnormalities in infertile men and women. Cytogenet Genome Res 2005;111(3–4):317–36.
- Tiepolo L, Zuffardi O. Localization of factors controlling spermatogenesis in the nonfluorescent portion of the human y chromosome long arm. Hum Genet 1976;34(2):119–24.
- Lahn BT, Pearson NM, Jegalian K. The human Y chromosome, in the light of evolution. Nat Rev Genet 2001;2(3):207–16.
- Foresta C, Ferlin A, Garolla A, Moro E, Pistorello M, Barbaux S, et al. High frequency of well-defined Y-chromosome deletions in idiopathic Sertoli cell-only syndrome. Hum Reprod 1998;13(2):302–7.
- Blagosklonova O. AZFa deletions in Sertoli cell-only syndrome: a retrospective study. Mol Hum Reprod 2000;6(9):795–9.
- Kamp C. High deletion frequency of the complete AZFa sequence in men with Sertoli-cell-only syndrome. Mol Hum Reprod 2001;7(10):987–94.
- Li LL, Zhu YZ, Yu XW, Wang RX, Hu ZM, Liu RZ. Pedigrees of infertile Chinese men with Y chromosome microdeletions derived from natural transmission and de novo mutation. Genet Mol Res 2015;14(1):1932–41.
- Vogt PH. AZF deletions and Y chromosomal haplogroups: history and update based on sequence. Hum Reprod Update 2005;11(4):319–36.
- Kichine E, Rozé V, Di Cristofaro J, Taulier D, Navarro A, Streichemberger E, et al. HSFY genes and the P4 palindrome in the AZFb interval of the human Y chromosome are not required for spermatocyte maturation. Hum Reprod 2012;27(2):615–24.
- Alechine E, Corach D. High-Throughput Screening for Spermatogenesis Candidate Genes in the AZFc Region of the Y Chromosome by Multiplex Real Time PCR Followed by High Resolution Melting Analysis. PLoS One 2014;9(5):e97227.
- Jobling M. Recurrent duplication and deletion polymorphisms on the long arm of the Y chromosome in normal males. Hum Mol Genet 1996;5(11):1767–75.
- Singer ST, Killilea D, Suh JH, Wang ZJ, Yuan Q, Ivani K, et al. Fertility in transfusion-dependent thalassemia men: effects of iron burden on the reproductive axis. Am J Hematol 2015;90(9):E190-2.
- Nakamura Y, Kitamura M, Nishimura K, Koga M, Kondoh N, Takeyama M, et al. Chromosomal variants among 1790 infertile men. Int J Urol. 2001 Feb;8(2):49–52.
- Bojesen A, Juul S, Gravholt CH. Prenatal and Postnatal Prevalence of Klinefelter Syndrome: A National Registry Study. J Clin Endocrinol Metab 2003;88(2):622–6.
- Danacıoglu YO, Yenice MG, Akkas F, Soytas M, Seyhan S, Tasci Aİ. The genetic causes of infertility in patients with oligozoospermia and azoospermia in Turkish population. Yeni Üroloji Derg 2021;16(16–2):159–64.
- Rossodivita A, Colabucci F. Short stature in a patient with Klinefelter syndrome and growth hormone deficiency. Am J Med Genet 1994;49(2):244–6.
- Ramesh J, Nagasatyavani M, Venkateswarlu J, Nagender J. An Unusual Combination of Klinefelter Syndrome and Growth Hormone Deficiency in a Prepubertal Child. J Clin Res Pediatr Endocrinol 2014;187–9.
- Sanz Marcos N, Turón Viñas A, Ibáñez Toda L. Síndrome de Klinefelter de presentación atípica. An Pediatría 2013;79(2):112–5.
- Fang H, Xu J, Wu H, Fan H, Zhong L. Combination of Klinefelter Syndrome and Acromegaly: A Rare Case Report. Medicine (Baltimore) 2016;95(17):e3444.
- Colaco S, Modi D. Genetics of the human Y chromosome and its association with male infertility. Reprod Biol Endocrinol 2018;16(1):14.
- Balkan M, Tekes S, Gedik A. Cytogenetic and Y chromosome microdeletion screening studies in infertile males with Oligozoospermia and Azoospermia in Southeast Turkey. J Assist Reprod Genet 2008;25(11–12):559–65.
- Mirfakhraie R, Mirzajani F, Kalantar SM, Montazeri M, Salsabili N, Pourmand GR, et al. High prevalence of AZFb microdeletion in Iranian patients with idiopathic non-obstructive azoospermia. Indian J Med Res 2010;132:265–70.
- Oud MS, Houston BJ, Volozonoka L, Mastrorosa FK, Holt GS, Alobaidi BKS, et al. Exome sequencing reveals variants in known and novel candidate genes for severe sperm motility disorders. Hum Reprod 2021;36(9):2597–611.