Disorder of Sexual Development and Congenital Heart Defect in 47XYY: Clinical Disorder or Coincidence?

Reproductive Outcomes of Infertile Males With Novel Genetic Defects

Various chromosomal structural aberrations and genetic mutations have been discovered in infertile couples. Some have no obvious loss of genetic material; they are usually phenotypically normal people with reproductive issues. Males with these illnesses may have infertility and abnormal sperm analysis. However, positive sperm have also been detected in the ejaculation of some patients. As a result, knowing about these problems and how common they are can influence the fertility treatment that couples receive to achieve pregnancy and the birth of healthy newborns.

Disorder of Sexual Development Males With XYY in Blood Have Exactly X/XY/XYY Mosaicism in Gonad Tissues

Y chromosome represents masculinization. The extra Y chromosome of XYY patients usually leads to over-masculinization phenotypes. The occurrence of several DSD cases with XYY in blood is controversial. Is XYY associated with disorder of sex development (DSD)? What is the mechanism behind DSD in males with XYY in blood? To this end, this study retrospectively analyzed blood-karyotype data of 4,437 DSD male children and karyotypes data of 6,259 newborn males as the control. Exome sequencing (ES) was performed to test whether the patients with DSD and with XYY in blood had other variants on known DSD-genes. Testicular biopsy was performed. Fluorescence in situ hybridization (FISH) was used to test whether a sex chromosome mosaicism was present in the oral epithelial cells or gonad tissue of patients with DSD and with XYY in blood. Among 4,437 DSD males who received cytogenetic evaluation, 14 patients with 47,XYY were identified. By contrast, five individuals among the 6,259 controls had 47,XYY. XYY in blood is more frequent among males with DSD than in other males (p = 0.004). The XYY karyotypes were confirmed again by GTG-banding in blood samples and by FISH performed on oral epithelial cells. ES on seven XYY DSD patients was successfully performed, but results did not identify any pathogenic variant on 55 known DSD genes. Gonad biopsy (n = 3) revealed testicular dysplasia and true hermaphroditism. FISH of gonad tissues (n = 3) showed that all of the samples had mosaic for X/XY/XYY. This study is the first to investigate the relationship between XYY in blood and DSD. The knowledge that XYY is in the blood and in oral cells have X/XY/XYY mosaicism in gonadal tissue is new for both researchers and clinicians who seek to understand the genetic basis of DSD males.

[Association between karyotype 47XYY and 5-alpha reductase deficiency revealed by micropenis: about a case and literature review]

Les sujets 47XYY ont souvent un fonctionnement gonadotrope normal, l’association à un déficit en 5alpha réductase chez ces sujets est rare ; la présentation clinique classique des déficits en 5 alpha réductase est un pseudohermaphrodisme masculin, rarement un micropénis comme mode de révélation. Le traitement par énanthate de testostérone du micropénis ne donne pas de bons résultats dans les déficits en 5alpha réductase, la dihydrotestostérone(DHT) à une efficacité prouvée dans ce cas. Nous rapportons l’observation d’un patient de 17 ans, référé dans notre formation pour la prise en charge d’un micropénis ne répondant pas aux 2 cures à base d’énanthate de testostérone. Le bilan notait une testostérone normale, des gonadotrophines à la limite supérieure de la normale, une DHT basse, avec augmentation du rapport testostérone/DHT > 20.caryotype 47XYY. Le déficit en 5 alpha réductase chez ces sujets pose la problématique d’une simple coïncidence, ou d’un lien effectif.