Amaç: Kromozomların heterokromatin bölgeleri, yüksek oranda tekrar dizileri içermektedir. Heterokromatin varyasyonları, mayoz bölünme sırasında hatalı kalıtım materyali içeren gametlerin oluşmasına, bu nedenle de infertiliteye ve tekrarlayan gebelik kayıplarına (TGK) yol açabilir. Bu çalışmada, heterokromatin varyasyon taşıyıcılığının, üreme başarısızlığı olan erkeklerde görülme sıklığının belirlenmesi amaçlanmıştır. Gereç ve Yöntemler: 2009-2019 yılları arasında infertilite ve eşinde TGK nedeni ile Mersin Üniversitesi Tıp Fakültesi Hastanesi Üroloji Ana Bilim Dalından, Postnatal Sitogenetik Analiz Laboratuvarına yönlendirilen 979 erkek hastanın karyotip bulguları değerlendirilmiştir. Hastalardan alınan periferik kan örneklerinin, konvansiyonel yöntemle karyotip analizi yapılmıştır. Mersin Üniversitesi Klinik Araştırmalar Etik Kurulundan, 19.02.2020 tarihli 2020/130 karar numaralı etik kurul onayı alınmıştır. Bulgular: Karyotip analizi yapılan 979 erkek hastanın 888'i normal kromozom kuruluşuna sahipken (46, XY), 91'inde sayısal ve yapısal anomaliler ile varyasyonlar saptanmıştır. Gonozomal kromozomların sayısal düzensizlikleri 40 (%43,96) kişide görülürken, otozomal ve gonozomal varyasyonlar 33 (%36,26) kişide tespit edilmiştir. 20 (%2,04) kişinin Yqh+ taşıyıcısı, 13 (%1,32) kişinin ise satellit polimorfizmi taşıdığı belirlenmiştir. Ayrıca hastaların %9,89'unda inversiyon (9) ve %9,89'unda translokasyon tipi yapısal düzensizlik tespit edilmiştir. Sonuç: Heterokromatin bölge varyasyon taşıyıcısı olan erkeklerde, mayoz bölünme sırasında bu bölgelerde oluşabilecek sinaptik hatalar nedeni ile kusurlu gamet oluşma riski yüksek olabilir. Bu durum, erkeklerde üreme başarısızlığına neden olabilir. Retrospektif çalışmalar sonucu kurulan bu hipotez ile mayoz bölünme sırasında gerçekleşen moleküler süreçler ayrıntılı olarak incelenerek desteklenmelidir.
Anahtar Kelimeler: Erkek infertilitesi; spontan abortus; heterokromatin; karyotip
Objective: The heterochromatin regions of the chromosomes contains highly repeat sequences. This squences may cause errors in synaptonemal complex during the meiosis, so that gametes containing faulty genetic material may occur. Thus leading to infertility and recurrent pregnancy losses. The aim of this study was to determine the incidence of heterochromatin carriers in men with reproductive failure. Material and Methods: 979 male subjects who were referred from Mersin University Hospital, from Urology Clinic to Postnatal Cytogenetic analysis laboratory for infertility and recurrent pregnancy loss between 2009-2019 years. Peripheral blood samples were obtained by conventional karyotype analysis. Ethics committee approval was received from Mersin University Clinical Research Ethics Committee with the decision number 2020/130 dated 19.02.2020. Results: 979 men whose karyotype analysis were performed, 888 of them had a normal karyotype (46, XY), and 91 had chromosomal abnormalities. Numerical abnormalities of gonosomal chromosomes were detected 40 (43.96%) patients. Also, autosomal and gonosomal variations were detected in 33 (36.26%) patients. Yqh + carriers number was 20 (2.04%), carriers of satellite polymorphism was 13 (1.32%) patients. In addition, 9.89% of them had inv (9) and 9.89% had translocations. Conclusion: Men with heterochromatin variations may have high risk for defective gametes due to the synaptic errors that may occur during meiosis. This variation may cause of reproductive failure in men. This hypothesis, which was established as a result of retrospective studies, should be supported in detail by examining the molecular processes during the meiosis.
Keywords: Male infertility; abortion spontaneous; heterochromatin; karyotype
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