Y-chromosome microdeletions and recurrent pregnancy loss.

ABSTRACT

OBJECTIVE: To determine the prevalence of Y-chromosome microdeletions in recurrent pregnancy loss (RPL) couples as compared with couples with male factor infertility and fertile couples. DESIGN: Controlled clinical study. SETTING: Andrology laboratory and RPL clinic. PATIENT(S) Seventeen men from RPL couples, 18 men from couples with a live birth and no history of miscarriages, and 10 men from couples with male factor infertility. INTERVENTION(S) Buccal smears for Y-chromosome microdeletion testing. MAIN OUTCOME MEASURE(S) The DNA was tested for microdeletions in the proximal AZFc region by polymerase chain reaction (PCR). RESULT(S) Fourteen of the 17 men (82%) tested had microdeletions in one or more of the four segments studied. Two of the 10 male factor infertility patients (20%) had microdeletions in 2 different segments. None of the 18 fertile men had any microdeletions in the 4 segments of the proximal AZFc region studied. CONCLUSION(S) The prevalence of the Y-chromosome microdeletions in the proximal AZFc region was much higher in men from RPL couples than from fertile or infertile couples. Although these patients are from a tertiary referral center that may skew the population and findings, one may consider Y-chromosome microdeletion testing particularly of the AZFc region in the evaluation of RPL couples when all other tests fail to reveal the etiology.