Male Infertility and the Y Chromosome

Abstract

Although it has been established since the 1970s thatdeletions of the long arm of the Y chromosome are as-sociated with spermatogenic failure, only in the last fewyears have these regions been described at the molecularlevel. In parallel, Y-linked genes and gene families thatmay explain the phenotypes of men carrying these de-letions have been identified. The first association be-tween spermatogenic failure and an underlying geneticcause was demonstrated by Tiepolo and Zuffardi (1976)in a report of six azoospermic patients carrying micro-scopically detectable deletions of the distal portion ofYq. In four patients, the deletion was de novo—that is,their fathers were tested and were found to carry intactY chromosomes. On this basis, Tiepolo and Zuffardi(1976) proposed the existence of a spermatogenesis fac-tor, called the “azoospermia factor” (AZF), encoded bya gene on distal Yq. However, the assumption that AZFrepresented a single Y-linked gene was overturned whenVogt et al. (1996) observed that Y chromosome micro-deletions follow a certain deletion pattern, with threerecurrently deleted nonoverlapping subregions in prox-imal, middle, and distal Yq11, designated “AZFa,”“AZFb,” and “AZFc,” respectively. In addition, it be-came clear that these deletions were not exclusively as-sociated with azoospermia (Reijo et al. 1996