Diagnostic test for Y chromosome microdeletion screening in male infertility.

Despite the current lack of understanding the mechanism of deleterious effects of Y chromosome microdeletions and their prognostic influence on male subfertility, the Y chromosome microdeletion test is widely used in the diagnostic evaluation of male subfertility. However, currently used diagnostic schemes have not been sufficiently evaluated for their diagnostic performance. The purpose of this study was to analyze a large database of published Y chromosome microdeletions to develop the optimal screening strategy for male subfertility. Therefore, we created a database from genetic and clinical data published in 52 peer-reviewed studies reporting on 512 cases with Y chromosome microdeletions. We developed a computerized procedure with the goal of minimizing the number of genetic markers included in the diagnostic set while maximizing the detection rate in patients with microdeletions. We estimate that 85.6% of all published Y chromosome microdeletions can be covered by a set of six genetic markers (sY84, sY127, sY152, RBMY1, sY147, sY254-DAZ). Inclusion of additional markers brings relatively little to the sensitivity of the test and is potentially related to the population origin.