Vol. 43 (4): 770-775, July – August, 2017
CHALLENGING CLINICAL CASES
Akinsal, Emre Can 1, Baydilli, Numan 1, Demirtas, Abdullah 1, Saatci, Cetin 2, Ekmekcioglu, Oguz 1
1 Department of Urology, Erciyes University Medical Faculty, Kayseri, Turkey; 2 Department of Genetics, Erciyes University Medical Faculty Medical, Kayseri, Turkey
Objective: To present clinical, chromosomal and hormonal features of ten cases with SRY-positive 46,XX testicular disorder of sex development who were admitted to our infertility clinic.
Cases and Methods: Records of the cases who were admitted to our infertility clinic between 2004 and 2015 were investigated. Ten 46,XX testicular disorder of sex development cases were detected. Clinical, hormonal and chromosomal assessments were analized.
Results: Mean age at diagnosis was 30.4, mean body height was 166.9cm. Hormonal data indicated that the patients had a higher FSH, LH levels, lower TT level and normal E2, PRL levels. Karyotype analysis of all patients confirmed 46,XX karyotype, and FISH analysis showed that SRY gene was positive and translocated to Xp. The AZFa, AZFb and AZFc regions were absent in 8 cases. In one case AZFb and AZFc incomplete deletion and normal AZFa region was present. In the other one all AZF regions were present.
Conclusion: Gonadal development disorders such as SRY-positive 46,XX testicular disorder of sex development can be diagnosed in infertility clinics during infertility workup. Although these cases had no chance of bearing a child, they should be protected from negative effects of testosterone deficiency by replacement therapies.
Keywords: Chromosomal abnormality, infertility, 46,XX testicular disorder of sex development