Khalil Faaed: Are Complex Y Chromosome Rearrangements the Missing Link in Unexplained Male Infertility?
Khalil Faaed, Embryologist at Modern IVF Center, shared a post on LinkedIn:
“Beyond Y Chromosome Microdeletions: Are Complex Y Chromosome Rearrangements the Missing Link in Unexplained Male Infertility?
Genetic evaluation of male infertility has traditionally focused on Y chromosome microdeletions (AZFa, AZFb, and AZFc). However, many men with severe spermatogenic failure or unexplained infertility remain without a definitive genetic diagnosis despite negative microdeletion testing.
An emerging explanation may be complex Y chromosome rearrangements (cYCRs) rare structural abnormalities involving multiple chromosomal breakpoints, translocations, inversions, insertions, or deletions. Rather than simply removing genetic material, these rearrangements can disrupt meiotic chromosome pairing, genomic architecture, and gene regulation, ultimately impairing spermatogenesis.
Clinically, cYCRs have been associated with severe oligozoospermia, non-obstructive azoospermia, recurrent reproductive failure, and an increased risk of chromosomally unbalanced gametes. Importantly, these abnormalities may occur without classical AZF microdeletions, highlighting a potential limitation of current diagnostic algorithms.
As high-resolution cytogenomic technologies become increasingly accessible, identifying complex Y chromosome rearrangements may improve genetic diagnosis, prognostic assessment, reproductive counseling, and individualized ART strategies.
Perhaps the next advance in male infertility genetics lies not only in identifying missing genes, but in understanding how the Y chromosome itself has been structurally reorganized.”
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