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Targeted next-generation sequencing panel screening of 668 Chinese patients with non-obstructive azoospermia

  • Genetics
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Abstract

Purpose

We aimed (1) to determine the molecular diagnosis rate and the recurrent causative genes of patients with non-obstructive azoospermia (NOA) using targeted next-generation sequencing (NGS) panel screening and (2) to discuss whether these genes help in the prognosis for microsurgical testicular sperm extraction (micro-TESE).

Methods

We used NGS panels to screen 668 Chinese men with NOA. Micro-TESE outcomes for six patients with pathogenic mutations were followed up. Functional assays were performed for two NR5A1 variants identified: p.I224V and p.R281C.

Results

Targeted NGS panel sequencing could explain 4/189 (2.1% by panel 1) or 10/479 (2.1% by panel 2) of the patients with NOA after exclusion of karyotype abnormalities and Y chromosome microdeletions. Almost all mutations detected were newly described except for NR5A1 p.R281C and TEX11 p.M156V. Two missense NR5A1 mutations—p.R281C and p.I244V—were proved to be deleterious by in vitro functional assays. Mutations in TEX11, TEX14, and NR5A1 genes are recurrent causes of NOA, but each gene explains only a very small percentage (less than 4/668; 0.6%). Only the patient with NR5A1 mutations produced viable spermatozoa through micro-TESE, but other patients with TEX11 and TEX14 had poor micro-TESE prognoses.

Conclusions

A targeted NGS panel is a feasible diagnostic method for patients with NOA. Because each gene implicated explains only a small proportion of such cases, more genes should be included to further increase the diagnostic rate. Considering previous reports, we suggest that only a few genes that are directly linked to meiosis can indicate poor micro-TESE prognosis, such as TEX11, TEX14, and SYCE1.

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Acknowledgments

The authors thank all enrolled patients. The authors also thank Li Zhang and Changquan Guo from Nuprobe company for analyzing data.

Funding

This study was supported by grants from the National Natural Science Foundation of China (81971376), a grant from the science and technology project of Pudong New Area Health and Family Planning Commission, Shanghai, China (XG8300000-2017-364), a grant from the Health Commission of Pudong New Area, Shanghai, P. R. China (PW2020D-7), a grant from Shanghai Municipal Health Commission for advanced and suitable technology promotion projects (2019SY056), and Clinical Research Plan of SHDC (No. SHDC2020CR4035).

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  1. Department of Urology and Andrology, Renji Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai, 200001, People’s Republic of China

    Miao An, Yidong Liu, Ming Zhang, Kai Hu, Yan Jin, Shiran Xu, Hongxiang Wang & Mujun Lu

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  1. Miao An
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  2. Yidong Liu
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Correspondence to Hongxiang Wang or Mujun Lu.

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An, M., Liu, Y., Zhang, M. et al. Targeted next-generation sequencing panel screening of 668 Chinese patients with non-obstructive azoospermia. J Assist Reprod Genet 38, 1997–2005 (2021). https://doi.org/10.1007/s10815-021-02154-9

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