A Rare Case of 46, XX (SRY+) With Normal Male Stature and Unilateral Absence of the Vas Deferens
Abstract
Objective: This study aimed to investigate the cause of primary infertility in a rare case with unilateral absence of vas deferens.
Case report: A 35-year-old man was presented to the Infertility Clinic at the National Center of Maternal and Child Health (NCMCH) with an eight-year history of primary infertility. Clinical examination showed a normal intelligence with a coarse facial appearance and small testicles. Hormonal tests detected elevated levels of prolactin (PRL), follicle stimulating hormone (FSH), and luteinizing hormone (LH), and low levels of testosterone. Chromosomal analysis with fluorescence in situ hybridization (FISH) revealed a 46XX with SRY (sex-determining region Y) positive karyotype with translocation of the SRY gene (46XX der(X)t(X:Y)(p11.1:p11.3)(SRY+)). Magnetic resonance imaging (MRI) revealed bilateral seminal vesicles atrophy and agenesis of the vas deferens on the right side, which is rarely found in 46, XX male syndrome.
Conclusion: Although 46XX testicular disorder of sexual development (DSD) cases are rare, multiple aspects of the clinical examinations are important to make an accurate diagnosis and to provide proper genetic counseling and guidance to patients in their long-term management
2. Boucekkine C, Toublanc JE, Abbas N, Chaabouni S, Ouahid S, Semrouni M, et al. Clinical and anatomical spectrum in XX sex reversed patients. Relationship to the presence of Y specific DNA‐sequences. Clin Endocrinol (Oxf) 1994; 40: 733–42.
3. Pleskacova J, Hersmus R, Oosterhuis JW, Setyawati BA, Faradz SM, Cools M, et al. Tumor Risk in Disorders of Sex Development. Sex Dev 2010; 4: 259–69.
4. Terribile M, Stizzo M, Manfredi C, Quattrone C, Bottone F, Giordano DR, et al. 46,XX Testicular Disorder of Sex Development (DSD): A Case Report and Systematic Review. Medicina (Kaunas) 2019; 55: 371.
5. Chen T, Tian L, Wu F, Xuan X, Ma G, Tang R, LU J. Clinical and genetic analysis in males with 46,XX disorders of sex development: A reproductive centre experience of 144 cases. Andrologia 2019; 51: e13232.
6. Grinspon RP, Rey RA. Disorders of Sex Development with Testicular Differentiation in SRY-Negative 46,XX Individuals: Clinical and Genetic Aspects. Sex Dev 2016; 10: 1–11.
7. World Health Organization (Western Pacific Region). Mongolian STEPS Survey on the Prevalence of Noncommunicable Disease Risk Factors 2006.
8. Adrião M, Ferreira S, Silva RS, Garcia M, Dória S, Costa C, et al. 46,XX male disorder of sexual development. Clin Pediatr Endocrinol 2020; 29: 43–5.
9. Aksglaede L, Skakkebaek NE, Juul A. Abnormal sex chromosome constitution and longitudinal growth: Serum levels of insulin-like growth factor (IGF)-I, IGF binding protein-3, luteinizing hormone, and testosterone in 109 males with 47,XXY, 47,XYY, or sex-determining region of the Y chromosome. J Clin Endocrinol Metab 2008; 93: 169–76.
10. Lai FY, Nath M, Hamby SE, Thompson JR, Nelson CP, Samani NJ. Adult height and risk of 50 diseases: A combined epidemiological and genetic analysis. BMC Med 2018; 16: 187.
Files | ||
Issue | Vol 15, No 4 (December 2021) | |
Section | Case Reports | |
DOI | https://doi.org/10.18502/jfrh.v15i4.7895 | |
Keywords | ||
Chromosomal Aberrations Male Infertility Magnetic Resonance Imaging Sexual Development 46, XX Testicular Disorders of Sex Development |
Rights and permissions | |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |