Illness46XY infertility / sterility, differential diagnosis
Summary
Comprehensive differential diagnostic panel for 46XY infertility / sterility comprising 10 guideline-curated and altogether some 109 curated genes according to the clinical signs
176,3 kb (Extended panel: incl. additional genes)
- EDTA-anticoagulated blood (3-5 ml)
NGS +
[Sanger]
Gene panel
Selected genes
Name | Exon Length (bp) | OMIM-G | Referenz-Seq. | Heredity |
---|---|---|---|---|
ADGRG2 | 3081 | NM_001079858.3 | XL | |
AMH | 1683 | NM_000479.5 | AR | |
AMHR2 | 1722 | NM_020547.3 | AR | |
ANOS1 | 2043 | NM_000216.4 | XLR | |
AR | 2763 | NM_000044.6 | XLR | |
AURKC | 930 | NM_001015878.2 | AR | |
CFTR | 4443 | NM_000492.4 | AD, AR | |
CHD7 | 8994 | NM_017780.4 | AD | |
CYP11A1 | 1566 | NM_000781.3 | AR, AD | |
CYP11B1 | 1512 | NM_000497.4 | AR | |
CYP17A1 | 1527 | NM_000102.4 | AR | |
CYP19A1 | 1512 | NM_031226.3 | AR | |
CYP21A2 | 1488 | NM_000500.9 | AR | |
FGFR1 | 2469 | NM_023110.3 | AR | |
GNRHR | 987 | NM_000406.3 | AR | |
HSD17B3 | 933 | NM_000197.2 | AR | |
HSD3B2 | 1119 | NM_000198.4 | AR | |
KISS1R | 1197 | NM_032551.5 | AR | |
LHB | 426 | NM_000894.3 | AR | |
LHCGR | 2100 | NM_000233.4 | AD, AR | |
NR0B1 | 1413 | NM_000475.5 | XL | |
NR5A1 | 1386 | NM_004959.5 | AD, AR | |
POU1F1 | 876 | NM_000306.4 | AD, AR | |
PROKR2 | 1155 | NM_144773.4 | AD, AR | |
PROP1 | 681 | NM_006261.5 | AR | |
SOX10 | 1401 | NM_006941.4 | AD | |
SRD5A2 | 764 | NM_000348.4 | AR | |
SRY | 615 | NM_003140.3 | YL | |
TACR3 | 1398 | NM_001059.3 | AR | |
TEX11 | 2822 | NM_031276.3 | XLR | |
APOA1 | 804 | NM_000039.3 | AD | |
BNC2 | 3297 | NM_017637.6 | AD | |
CATSPER2 | 1593 | NM_172095.4 | n.k. | |
CCDC141 | 4895 | NM_173648.4 | AD, AR | |
CCDC39 | 2826 | NM_181426.2 | AR | |
CCDC40 | 3429 | NM_017950.4 | AR | |
CDC14A | 2176 | NM_033312.3 | AR | |
CEP290 | 7440 | NM_025114.4 | AR | |
CFAP251 | 3505 | NM_144668.6 | AR | |
CFAP43 | 5231 | NM_025145.7 | AR | |
CFAP44 | 5815 | NM_001164496.2 | AR | |
CFAP69 | 2914 | NM_001039706.3 | AR | |
DMRT1 | 1122 | NM_021951.3 | AD | |
DNAAF2 | 2370 | NM_018139.3 | AR | |
DNAAF4 | 1131 | NM_001033559.3 | AD, AR | |
DNAAF6 | 651 | NM_001169154.2 | XLR | |
DNAH1 | 12798 | NM_015512.5 | AR | |
DPY19L2 | 2277 | NM_173812.5 | AR | |
FANCA | 4368 | NM_000135.4 | AR | |
FANCM | 6147 | NM_020937.4 | AR, Sus | |
FGF8 | 735 | NM_033163.5 | AD | |
FSHB | 390 | NM_000510.4 | AR | |
FSHR | 2088 | NM_000145.4 | AR | |
GATA4 | 1329 | NM_002052.5 | AD | |
GNRH1 | 291 | NM_000825.3 | AR | |
HS6ST1 | 1236 | NM_004807.3 | AD | |
INSL3 | 474 | NM_005543.4 | AD | |
KLHL10 | 1827 | NM_152467.5 | AD | |
MAMLD1 | 2325 | NM_005491.4 | XLR | |
PLCZ1 | 1827 | NM_033123.4 | AR | |
PLXNA1 | 5691 | NM_032242.4 | n.k. | |
PMFBP1 | 3170 | NM_031293.3 | AR | |
PROK2 | 390 | NM_001126128.2 | AD, AR | |
RSPO1 | 792 | NM_001038633.4 | AR | |
SEMA3A | 2316 | NM_006080.3 | AD | |
SOX2 | 954 | NM_003106.4 | AD | |
SOX3 | 1341 | NM_005634.3 | XL | |
SOX9 | 1530 | NM_000346.4 | AD | |
SUN5 | 1397 | NM_080675.4 | AR | |
SYCP3 | 711 | NM_153694.5 | AD | |
TEX15 | 9537 | NM_001350162.2 | AR | |
WDR11 | 3675 | NM_018117.12 | AD | |
WT1 | 1569 | NM_024426.6 | AD, SMu | |
XRCC2 | 843 | NM_005431.2 | AR |
Informations about the disease
Infertility is defined as the inability to become pregnant within one year of unprotected sexual intercourse. Approximately 7% of the male population is affected, which explains the infertility in half of all affected couples. The etiology of male infertility is very complex, and at least 15% of all infertile men show genetic abnormalities. The critical causes of male infertility include sexual differentiation, genitourinary system development, and gametogenesis. Sex chromosome abnormalities play an important role in severe impairments of spermatogenesis, and at least 2,000 genes are involved in spermatogenesis. Nearly a quarter of the known genetic factors contributing to male infertility result in azoospermia. Autosomal gene mutations mainly cause central hypogonadism, teratozoospermia or asthenozoospermia, congenital obstructive azoospermia, and familial cases of quantitative spermatogenesis disorders. Genetic diagnoses begin with karyotyping, deletion analysis of azoospermia factor (AZF) and mutation analysis in the cystic fibrosis transmembrane conductance regulator (CFTR) gene. Currently, molecular genetic diagnosis can be confirmed in approximately 5% of infertile men using a more comprehensive gene panel. An inconspicuous genetic finding does not imply exclusion of the suspected clinical diagnosis.
References: https://pubmed.ncbi.nlm.nih.gov/29622783/
https://doi.org/10.1093/humrep/dez022
https://pubmed.ncbi.nlm.nih.gov/31347970/
- Alias: Asthenospermia
- Alias: Asthenospermie
- Alias: Azoospermia
- Alias: Azoospermie
- Alias: Oligospermia
- Alias: Oligospermie
- Allelic: Acampomelic campomelic dysplasia (SOX9)
- Allelic: Adrenal hyperplasia, congenital, due to 21-hydroxylase deficiency (CYP21A2)
- Allelic: Aldosteronism, glucocorticoid-remediable (CYP11B1)
- Allelic: Atrial septal defect 2 (GATA4)
- Allelic: Atrioventricular septal defect 4 (GATA4)
- Allelic: Campomelic dysplasia (SOX9)
- Allelic: Cystic fibrosis (CFTR)
- Allelic: Deafness, AD 34, with/-out inflammation (NLRP3)
- Allelic: Dyslexia, susceptibility to, 1 (DNAAF4)
- Allelic: Encephalitis/encephalopathy, mild, with reversible myelin vacuolization (MYRF)
- Allelic: Familial cold inflammatory syndrome 1 (NLRP3)
- Allelic: Hydrocephalus, normal pressure, 1 (CFAP43)
- Allelic: Hypertrypsinemia, neonatal (CFTR)
- Allelic: Keratoendothelitis fugax hereditaria (NLRP3)
- Allelic: Leber congenital amaurosis 10 (CEP290)
- Allelic: Mesothelioma, somatic (WT1)
- Allelic: Nephrotic syndrome, type 4 (WT1)
- Allelic: Ovarian dysgenesis 1 (FSHR)
- Allelic: Ovarian hyperstimulation syndrome (FSHR)
- Allelic: Ovarian response to FSH stimulation (FSHR)
- Allelic: Pancreatitis, hereditary (CFTR)
- Allelic: Pregnancy loss, recurrent, 4 (SYCP3)
- Allelic: Premature ovarian failure 15 (FANCM)
- Allelic: Premature ovarian failure 17 (XRCC2)
- Allelic: Primary ovary insufficiency [panelapp] (IGSF10)
- Allelic: Prostate cancer, susceptibility to (AR)
- Allelic: Spinal + bulbar muscular atrophy of Kennedy (AR repeat)
- Allelic: Sweat chloride elevation without CF (CFTR)
- Allelic: Tetralogy of Fallot (GATA4)
- Allelic: Ventricular septal defect 1 (GATA4)
- Allelic: Wilms tumor, type 1 (WT1)
- 17,20-lyase deficiency, isolated (CYP17A1)
- 17-alpha-hydroxylase/17,20-lyase deficiency (CYP17A1)
- 46XY sex reversal 11 (DHX37)
- Adrenal hyperplasia, congenital, due to 11-beta-hydroxylase deficiency (CYP11B1)
- Adrenal insufficiency, congenital, with 46XY sex reversal, partial or complete (CYP11A1)
- Amyloidosis, 3 or more types (APOA1)
- Androgen insensitivity (AR)
- Androgen insensitivity, partial, with/-out breast cancer (AR)
- Anosmic hypogonadotropic hypogonadism [panelapp] (CCDC141)
- Aromatase deficiency (CYP19A1)
- Aromatase excess syndrome (CYP19A1)
- Bardet-Biedl syndrome 14 (CEP290)
- Bronchiectasis with/-out elevated sweat chloride 1, modifier of (CFTR)
- CINCA syndrome (NLRP3)
- Campomelic dysplasia with autosomal sex reversal (SOX9)
- Cardiac-urogenital syndrome (MYRF)
- Ciliary dyskinesia, primary, 10 (DNAAF2)
- Ciliary dyskinesia, primary, 14 (CCDC39)
- Ciliary dyskinesia, primary, 15 (CCDC40)
- Ciliary dyskinesia, primary, 25 (DNAAF4)
- Ciliary dyskinesia, primary, 3, with/-out situs inversus (DNAH5)
- Ciliary dyskinesia, primary, 32 (RSPH3)
- Ciliary dyskinesia, primary, 36, XL (DNAAF6)
- Ciliary dyskinesia, primary, 37 (DNAH1)
- Ciliary dyskinesia, primary, 7, with/-out situs inversus (DNAH11)
- Congenital bilateral absence of vas deferens (CFTR)
- Congenital hypogonadotropic hypogonadism [MONDO:0015770] (CCDC141)
- Cryptorchidism (INSL3)
- Deafness, AR 32, with/-out immotile sperm /CDC14A)
- Deafness, autosomal recessive 32, with or without immotile sperm (CDC14A)
- Delayed puberty [panelapp] (IGSF10)
- Denys-Drash syndrome (WT1)
- Fanconi anemia compelmentation group A (FANCA)
- Fanconi anemia, complementation group U (XRCC2)
- Frasier syndrome (WT1)
- Heterotaxy, visceral, 9, autosomal, with male infertility (MNS1)
- Hydatidiform mole, recurrent, 3 (MEI1)
- Hyperandrogenism, nonclassic type, due to 21-hydroxylase deficiency (CYP21A2)
- Hypoalphalipoproteinemia, primary, 2 (APOA1)
- Hypoalphalipoproteinemia, primary, 2, intermediate (APOA1)
- Hypogonadotropic hypogonadism 1 with/-out anosmia; Kallmann syndrome 1 (ANOS1)
- Hypogonadotropic hypogonadism 11 with/-out anosmia (TACR3)
- Hypogonadotropic hypogonadism 12 with/-out anosmia (GNRH1)
- Hypogonadotropic hypogonadism 14 with/-out anosmia (WDR11)
- Hypogonadotropic hypogonadism 15 with/-out anosmia (HS6ST1)
- Hypogonadotropic hypogonadism 16 with/-out anosmia (SEMA3A)
- Hypogonadotropic hypogonadism 18 with/-out anosmia (IL17RD)
- Hypogonadotropic hypogonadism 2 with/-out anosmia (FGFR1)
- Hypogonadotropic hypogonadism 20 with/-out anosmia (FGF17)
- Hypogonadotropic hypogonadism 23 with/-out anosmia (LHB)
- Hypogonadotropic hypogonadism 24 without anosmia (FSHB)
- Hypogonadotropic hypogonadism 3 with/-out anosmia (PROKR2)
- Hypogonadotropic hypogonadism 4 with/-out anosmia (PROK2)
- Hypogonadotropic hypogonadism 6 with/-out anosmia (FGF8)
- Hypogonadotropic hypogonadism 7 without anosmia (GNRHR)
- Hypogonadotropic hypogonadism [panelapp] (IGSF10)
- Hypospadias 2, XL (MAMLD1)
- Infertility, male [jte-titled from lit.] (DDX3Y)
- Intellectual developmental disorder, XL, with isolated growth hormone deficiency (SOX3)
- Joubert syndrome 5 (CEP290)
- Lipoid adrenal hyperplasia (STAR)
- Lower urinary tract obstruction, congenital (BNC2)
- Meacham syndrome (WT1)
- Meckel syndrome 4 (CEP290)
- Microphthalmia, syndromic 3 (SOX2)
- Microphthalmia, syndromic 6 (BPM4)
- Muckle-Wells syndrome (NLRP3)
- Neurodevelopmental disorder with brain anomalies with/-out vertebral/cardiac anomalies (DHX37)
- Optic nerve hypoplasia + abnormalities of the central nervous system (SOX2)
- Orofacial cleft 11 (BPM4)
- Palmoplantar hyperkeratosis + true hermaphroditism (RSPO1)
- Palmoplantar hyperkeratosis with squamous cell carcinoma of skin + sex reversal (RSPO1)
- Panhypopituitarism, XL (SOX3)
- Pituitary hormone deficiency, combined or isolated, 1 (POU1F1)
- Pituitary hormone deficiency, combined, 2 (PROP1)
- Polycystic kidney disease 1 (PKD1)
- Pseudovaginal perineoscrotal hypospadias (SRD5A2)
- Senior-Loken syndrome 6 (CEP290)
- Spermatogenic failure (HSF2)
- Spermatogenic failure 1 (SYCP2)
- Spermatogenic failure 10 (SEPTIN12)
- Spermatogenic failure 11 (KLHL10)
- Spermatogenic failure 16 (SUN5)
- Spermatogenic failure 17 (PLCZ1)
- Spermatogenic failure 18 (DNAH1)
- Spermatogenic failure 19 (CFAP43)
- Spermatogenic failure 20 (CFAP44)
- Spermatogenic failure 23 (TEX14)
- Spermatogenic failure 24 (CFAP69)
- Spermatogenic failure 25 (TEX15)
- Spermatogenic failure 26 (TSGA10)
- Spermatogenic failure 28 (FANCM)
- Spermatogenic failure 31 (PMFBP1)
- Spermatogenic failure 33 (CFAP251)
- Spermatogenic failure 34 (FSIP2)
- Spermatogenic failure 35 (QRICH2)
- Spermatogenic failure 38 (ARMC2)
- Spermatogenic failure 39 (DNAH17)
- Spermatogenic failure 4 (SYCP3)
- Spermatogenic failure 40 (CFAP65)
- Spermatogenic failure 42 (TTC29)
- Spermatogenic failure 43 (SPEF2)
- Spermatogenic failure 48 (M1AP)
- Spermatogenic failure 50 (XRCC2)
- Spermatogenic failure 51 (CFAP91)
- Spermatogenic failure 6 (SPATA16)
- Spermatogenic failure, XL 2 (TEX11)
- Testicular anomalies with/-out congenital heart disease (GATA4)
- AD
- AR
- SMu
- Sus
- XL
- XLR
- YL
- n.k.
- Multiple OMIM-Ps
Bioinformatics and clinical interpretation
Test-Stärken
- DAkkS-akkreditiertes Labor
- EU-Richtlinie für IVD in Umsetzung
- Qualitäts-kontrolliert arbeitendes Personal
- Leistungsstarke Sequenzierungstechnologien, fortschrittliche Target-Anreicherungsmethoden und Präzisions-Bioinformatik-Pipelines sorgen für überragende analytische Leistung
- Sorgfältige Kuratierung klinisch relevanter und wissenschaftlich begründeter Gen-Panels
- eine Vielzahl nicht Protein-kodierender Varianten, die in unseren klinischen NGS-Tests mit erfasst werden
- unser strenges Variantenklassifizierungsschema nach ACMG-Kriterien
- unser systematischer klinischer Interpretations-Workflow mit proprietärer Software ermöglicht die genaue und nachvollziehbare Verarbeitung von NGS-Daten
- unsere umfassenden klinischen Aussagen
Testeinschränkungen
- Gene mit eingeschränkter Abdeckung werden gekennzeichnet
- Gene mit kompletten oder partiellen Duplikationen werden gekennzeichnet
- es wird angenommen, dass ein Gen suboptimal abgedeckt ist, wenn >90% der Nukleotide des Gens bei einem Mapping-Qualitätsfaktor von >20 (MQ>20) nicht abgedeckt sind
- die Sensitivität der Diagnostik zur Erkennung von Varianten mit genannten Testeinschränkungen ist möglicherweise begrenzt bei:
- Gen-Konversionen
- komplexe Inversionen
- Balancierte Translokationen
- Mitochondriale Varianten
- Repeat-Expansionen, sofern nicht anders dokumentiert
- nicht kodierende Varianten, die Krankheiten verursachen, die von diesem Panel nicht mit abgedeckt werden
- niedriger Mosaik-Status
- Repeat-Blöcke von Mononukleotiden
- Indels >50bp (Insertionen-Deletionen)
- Deletionen oder Duplikationen einzelner Exons
- Varianten innerhalb von Pseudogenen
- die analytische Sensitivität kann geringer ausfallen werden, wenn die DNA nicht von amedes genetics extrahiert wurde
Laboratory requirement
Die in grün gezeigten Gene sind kuratiert und werden als Gen-Panel untersucht. Eine Erweiterung des Panels (blau gezeigte Gene, jeweils ebenfalls kuratiert) kann auf Anfrage erfolgen. Sofern unter "Erweitertes Panel" ein Minuszeichen angezeigt wird, sind nur Core-/Basis-Gene verfügbar.
Für die Anforderung einer genetischen Untersuchung senden Sie uns bitte die Krankheits-ID auf einem Überweisungsschein. Bitte die Material-Angabe beachten.
Für privat versicherte Patienten empfehlen wir einen Antrag auf Kostenübernahme bei der Krankenversicherung.
Die Untersuchung wird auch für Selbstzahler angeboten.