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Lindgren I, Nenonen H, Henic E, Bungum L, Prahl A, Bungum M, Leijonhufvud I, Huhtaniemi I, Yding Andersen C, Lundberg Giwercman Y. Gonadotropin receptor variants are linked to cumulative live birth rate after in vitro fertilization. J Assist Reprod Genet 2018; 36:29-38. [PMID: 30232643 PMCID: PMC6338601 DOI: 10.1007/s10815-018-1318-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Accepted: 09/11/2018] [Indexed: 01/06/2023] Open
Abstract
Purpose The objective was to investigate if the gonadotropin receptor variants N680S (N: asparagine, S: serine, rs6166) in the follicle-stimulating hormone receptor (FSHR) and N312S (rs2293275) in the luteinizing hormone/human chorionic gonadotropin receptor (LHCGR) predicted cumulative live birth rate after in vitro fertilization (IVF). Methods A total of 665 women were consecutively enrolled for IVF during the period 2007–2016. Inclusion criteria were < 40 years of age, body mass index < 30 kg/m2, non-smoking, regular menstruation cycle of 21–35 days, and bilateral ovaries. A blood sample was drawn for endocrine hormonal analysis and for DNA extraction with subsequent genotyping of the FSHR N680S and LHCGR N312S polymorphisms. Statistical analyses were done on all completed IVF cycles. Results Women homozygous for S in both receptors combined (4S) had significantly higher live birth rate compared to those with other receptor variants when combining the first three IVF cycles (OR = 2.00, 95% CI [1.02, 3.92], p = 0.043). Cumulatively higher chance of live birth rate, during all IVF cycles, was also evident (HR = 1.89, 95% CI [1.00, 3.57], p = 0.049). Conclusions Gonadotropin receptor variants are promising candidates for the prediction of the possibility to have a baby to take home after IVF treatment.
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Affiliation(s)
- I. Lindgren
- Department of Translational Medicine, Molecular Genetic Reproductive Medicine, Clinical Research Centre, Lund University, Jan Waldenströms gata 35, Building 91, Plan 10, SE 21428 Malmö, Sweden
| | - H. Nenonen
- Department of Translational Medicine, Molecular Genetic Reproductive Medicine, Clinical Research Centre, Lund University, Jan Waldenströms gata 35, Building 91, Plan 10, SE 21428 Malmö, Sweden
| | - E. Henic
- Reproductive Medicine Centre, Skåne University Hospital, JanWaldenströms gata 47, Plan 3, SE 21428 Malmö, Sweden
| | - L. Bungum
- Department of Obstetrics and Gynecology, Herlev Hospital, Herlev Ringvej 75, 2730 Herlev, Denmark
| | - A. Prahl
- Department of Translational Medicine, Molecular Genetic Reproductive Medicine, Clinical Research Centre, Lund University, Jan Waldenströms gata 35, Building 91, Plan 10, SE 21428 Malmö, Sweden
| | - M. Bungum
- Reproductive Medicine Centre, Skåne University Hospital, JanWaldenströms gata 47, Plan 3, SE 21428 Malmö, Sweden
| | - I. Leijonhufvud
- Reproductive Medicine Centre, Skåne University Hospital, JanWaldenströms gata 47, Plan 3, SE 21428 Malmö, Sweden
| | - I. Huhtaniemi
- Hammersmith Campus, Institute of Reproductive and Developmental Biology, Imperial College London, London, SW7 2AZ UK
| | - C. Yding Andersen
- Laboratory of Reproductive Biology, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark
| | - Y. Lundberg Giwercman
- Department of Translational Medicine, Molecular Genetic Reproductive Medicine, Clinical Research Centre, Lund University, Jan Waldenströms gata 35, Building 91, Plan 10, SE 21428 Malmö, Sweden
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Isaksson S, Bogefors K, Ståhl O, Eberhard J, Giwercman YL, Leijonhufvud I, Link K, Øra I, Romerius P, Bobjer J, Giwercman A. High risk of hypogonadism in young male cancer survivors. Clin Endocrinol (Oxf) 2018; 88:432-441. [PMID: 29245176 DOI: 10.1111/cen.13534] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2017] [Revised: 11/08/2017] [Accepted: 12/10/2017] [Indexed: 01/09/2023]
Abstract
OBJECTIVE Cancer and its treatment in childhood and young adulthood can cause hypogonadism, leading to increased risk of long-term morbidity and mortality. The aim of this study was to evaluate the risk of presenting with biochemical signs of hypogonadism in testicular cancer survivors (TCS) and male childhood cancer survivors (CCS) in relation to the type of treatment given. DESIGN Case-control study. PATIENTS Ninety-two TCS, 125 CCS (mean age 40 and median age 34 years, respectively; mean follow-up time 9.2 and 24 years, respectively) and a corresponding number of age-matched controls. MEASUREMENTS Fasting morning blood samples were analysed for total testosterone (TT), follicle-stimulating hormone (FSH) and luteinizing hormone (LH). The odds ratios (OR) for hypogonadism, defined as primary, secondary, compensated or ongoing androgen replacement, were calculated for TCS and CCS and for subgroups defined by diagnosis and treatment. RESULTS Hypogonadism was found in 26% of CCS and 36% of TCS, respectively (OR: 2.1, P = .025 and OR = 2.3, P = .021). Among CCS, the OR was further increased in those given testicular irradiation (OR = 28, P = .004). Radiotherapy other than cranial or testicular irradiation plus chemotherapy, or cranial irradiation without chemotherapy, associated also with increased ORs (OR = 3.7, P = .013, and OR = 4.4, P = .038, respectively). Among TCS, those receiving >4 cycles of cisplatin-based chemotherapy had OR = 17, P = .015. CONCLUSIONS Biochemical signs of testosterone deficiency are recognized as markers of decreased life expectancy. Thus, the risk of hypogonadism in TCS and CCS should be recognized and emphasizes the need of long-term follow-up for these men.
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Affiliation(s)
- S Isaksson
- Molecular Reproductive Medicine Unit, Department of Translational Medicine, Lund University, Malmö, Sweden
- Department of Oncology, Skane University Hospital, Malmö and Lund, Sweden
| | - K Bogefors
- Molecular Reproductive Medicine Unit, Department of Translational Medicine, Lund University, Malmö, Sweden
- Department of Oncology, Skane University Hospital, Malmö and Lund, Sweden
| | - O Ståhl
- Department of Oncology, Skane University Hospital, Malmö and Lund, Sweden
| | - J Eberhard
- Department of Oncology, Skane University Hospital, Malmö and Lund, Sweden
| | - Y L Giwercman
- Molecular Reproductive Medicine Unit, Department of Translational Medicine, Lund University, Malmö, Sweden
| | - I Leijonhufvud
- Molecular Reproductive Medicine Unit, Department of Translational Medicine, Lund University, Malmö, Sweden
- Reproductive Medicine Centre, Skane University Hospital, Malmö, Sweden
| | - K Link
- Molecular Reproductive Medicine Unit, Department of Translational Medicine, Lund University, Malmö, Sweden
| | - I Øra
- Department of Pediatrics, Pediatric Oncology, Clinical Sciences, Lund University, Lund, Sweden
| | - P Romerius
- Department of Pediatrics, Pediatric Oncology, Clinical Sciences, Lund University, Lund, Sweden
| | - J Bobjer
- Molecular Reproductive Medicine Unit, Department of Translational Medicine, Lund University, Malmö, Sweden
- Department of Urology, Skane University Hospital, Malmö, Sweden
| | - A Giwercman
- Molecular Reproductive Medicine Unit, Department of Translational Medicine, Lund University, Malmö, Sweden
- Reproductive Medicine Centre, Skane University Hospital, Malmö, Sweden
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Lindgren I, Bååth M, Uvebrant K, Dejmek A, Kjaer L, Henic E, Bungum M, Bungum L, Cilio C, Leijonhufvud I, Skouby S, Andersen CY, Giwercman YL. Combined assessment of polymorphisms in the LHCGR and FSHR genes predict chance of pregnancy after in vitro fertilization. Hum Reprod 2016; 31:672-83. [PMID: 26769719 DOI: 10.1093/humrep/dev342] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Accepted: 12/17/2015] [Indexed: 11/13/2022] Open
Abstract
STUDY QUESTION Can gonadotrophin receptor variants separately or in combination, be used for the prediction of pregnancy chances in in vitro fertilization (IVF) trials? SUMMARY ANSWER The luteinizing hormone/human chorionic gonadotrophin receptor (LHCGR) variant N312S and the follicle-stimulating hormone receptor (FSHR) variant N680S can be utilized for the prediction of pregnancy chances in women undergoing IVF. WHAT IS KNOWN ALREADY The FSHR N680S polymorphism has been shown to affect the ovarian response in response to gonadotrophin treatment, while no information is currently available regarding variants of the LHCGR in this context. STUDY DESIGN, SIZE, DURATION Cross-sectional study, duration from September 2010 to February 2015. Women undergoing IVF were consecutively enrolled and genetic variants compared between those who became pregnant and those who did not. The study was subsequently replicated in an independent sample. Granulosa cells from a subset of women were investigated regarding functionality of the genetic variants. PARTICIPANTS/MATERIALS, SETTING, METHODS Women undergoing IVF (n = 384) were enrolled in the study and genotyped. Clinical variables were retrieved from medical records. For replication, an additional group of n = 233 women was utilized. Granulosa cells from n = 135 women were isolated by flow cytometry, stimulated with Follitropin alpha or Menotropin, and the downstream targets 3',5'-cyclic adenosine monophosphate (cAMP) and inositol 1,4,5-trisphosphate (IP3) measured with enzyme-linked immunosorbent assay. MAIN RESULTS AND THE ROLE OF CHANCE Women homozygous for serine (S) in both polymorphisms displayed higher pregnancy rates than women homozygous asparagine (N) (OR = 14.4, 95% CI: [1.65, 126], P = 0.016). Higher pregnancy rates were also evident for women carrying LHCGR S312, regardless of FSHR variant (OR = 1.61, 95% CI: [1.13, 2.29], P = 0.008). These women required higher doses of FSH for follicle recruitment than women homozygous N (161 versus 148 IU, P = 0.030). When combining the study cohort with the replication cohort (n = 606), even stronger associations with pregnancy rates were noted for the combined genotypes (OR = 11.5, 95% CI: [1.86, 71.0], P = 0.009) and for women carrying LHCGR S312 (OR = 1.49, 95% CI: [1.14, 1.96], P = 0.004). A linear significant trend with pregnancy rate and increasing number of G alleles was also evident in the merged study population (OR = 1.34, 95% CI: [1.10, 1.64], P = 0.004). A lower cAMP response in granulosa cells was noted following Follitropin alpha stimulation for women homozygous N in both polymorphisms, compared with women with other genotypes (0.901 pmol cAMP/mg total protein versus 2.19 pmol cAMP/mg total protein, P = 0.035). LIMITATIONS, REASONS FOR CAUTION Due to racial differences in LHCGR genotype distribution, these results may not be applicable for all populations. WIDER IMPLICATIONS OF THE FINDINGS Despite that >250 000 cycles of gonadotrophin stimulations are performed annually worldwide prior to IVF, it has not been possible to predict neither the pregnancy outcome, nor the response to the hormone with accuracy. If LHCGR and FSHR variants are recognized as biomarkers for chance of pregnancy, more individualized and thereby more efficient treatment modalities can be developed. STUDY FUNDING, COMPETING INTERESTS This work was supported by Interreg IV A, EU (grant 167158) and ALF governments grant (F2014/354). Merck-Serono (Darmstadt, Germany) supported the enrollment of the subjects. The authors declare no conflict of interest.
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Affiliation(s)
- I Lindgren
- Department of Translational Medicine, Molecular Genetic Reproductive Medicine, Clinical Research Centre, Lund University, Jan Waldenströms gata 35, Building 91, Plan 10, SE 20502 Malmö, Sweden
| | - M Bååth
- Department of Translational Medicine, Molecular Genetic Reproductive Medicine, Clinical Research Centre, Lund University, Jan Waldenströms gata 35, Building 91, Plan 10, SE 20502 Malmö, Sweden
| | - K Uvebrant
- Department of Clinical Sciences, Cellular Autoimmunity Unit, Clinical Research Centre, Lund University, Jan Waldenströms gata 35, Building 91, Plan 10, SE 20502 Malmö, Sweden
| | - A Dejmek
- Department of Clinical Pathology, University and Regional Laboratories, Skåne University Hospital, Jan Waldenströms gata 59, SE 20502 Malmö, Sweden
| | - L Kjaer
- Department of Translational Medicine, Molecular Genetic Reproductive Medicine, Clinical Research Centre, Lund University, Jan Waldenströms gata 35, Building 91, Plan 10, SE 20502 Malmö, Sweden
| | - E Henic
- Reproductive Medicine Centre, Skåne University Hospital, Jan Waldenströms gata 47, Plan 3, SE 20502 Malmö, Sweden
| | - M Bungum
- Reproductive Medicine Centre, Skåne University Hospital, Jan Waldenströms gata 47, Plan 3, SE 20502 Malmö, Sweden
| | - L Bungum
- Department of Obstetrics and Gynecology, Herlev Hospital, Herlev Ringvej 75, 2730 Herlev, Denmark
| | - C Cilio
- Department of Clinical Sciences, Cellular Autoimmunity Unit, Clinical Research Centre, Lund University, Jan Waldenströms gata 35, Building 91, Plan 10, SE 20502 Malmö, Sweden
| | - I Leijonhufvud
- Reproductive Medicine Centre, Skåne University Hospital, Jan Waldenströms gata 47, Plan 3, SE 20502 Malmö, Sweden
| | - S Skouby
- Department of Obstetrics and Gynecology, Herlev Hospital, Herlev Ringvej 75, 2730 Herlev, Denmark
| | - C Yding Andersen
- Laboratory of Reproductive Biology, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark
| | - Y Lundberg Giwercman
- Department of Translational Medicine, Molecular Genetic Reproductive Medicine, Clinical Research Centre, Lund University, Jan Waldenströms gata 35, Building 91, Plan 10, SE 20502 Malmö, Sweden
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Kvist L, Giwercman A, Weihe P, Kold Jensen T, Grandjean P, Halling J, Skaalum Petersen M, Lundberg Giwercman Y. Exposure to persistent organic pollutants and sperm sex chromosome ratio in men from the Faroe Islands. Environ Int 2014; 73:359-364. [PMID: 25222300 PMCID: PMC4413009 DOI: 10.1016/j.envint.2014.09.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2014] [Revised: 08/26/2014] [Accepted: 09/01/2014] [Indexed: 05/30/2023]
Abstract
People in the Arctic as well as fishermen on the polluted Swedish east coast are highly exposed to persistent organic pollutants (POPs). These compounds have been shown to affect the sperm Y:X chromosome ratio. In present study, the aim was to investigate whether polychlorinated biphenyl (PCB) congeners and 1,1,-dichloro-2,2,-bis(p-chlorophenyl)ethane (p,p'-DDE) influence sperm sex chromosome ratio in Faroese men, and whether these men differ regarding Y:X ratio compared to Greenland Inuit and Swedish fishermen. The study population (n=449) consisted of young men from the general population (n=276) as well as proven fertile men (n=173). The Y:X ratio was assessed by fluorescent in situ hybridization. Serum concentrations of POPs were measured using gas chromatography. Associations between POP concentrations and Y:X ratio were calculated using linear and non-linear regression models as well as trend analysis and pairwise comparison of exposure data categorized into quartiles. The selected POPs were associated with Y:X ratio in fertile Faroese men, but not in the total population; p,p'-DDE (95% CI for B=-0.005 to -0.001, p=0.005) and ΣPCB (95% CI for B=-0.005 to -0.001, p=0.012). Since p,p'-DDE and ΣPCB correlated significantly (r=0.927, p<0.001), the results involving the exposure variables can be regarded as a single finding. The Y:X ratio for the total Faroese population was 0.500±0.018, which was statistically significantly lower than in both Inuit and Swedish fishermen (0.512 for both). In conclusion, Faroese men presented with lower Y:X ratio than Greenland Inuit and Swedish fishermen. Although no direct health effects are expected due to the lower Faroese Y:X ratio, it could be indicative of adverse effects on the reproductive system.
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Affiliation(s)
- L Kvist
- Department of Clinical Sciences, Molecular Genetic Reproductive Medicine, Lund University, Malmö 20502, Sweden.
| | - A Giwercman
- Reproductive Medicine Centre, Skåne University Hospital, Malmö 20502, Sweden; Department of Clinical Sciences, Molecular Reproductive Research, Lund University, Malmö 20502, Sweden
| | - P Weihe
- Department of Occupational Medicine and Public Health, Faroese Hospital System, Tórshavn FO-110, Faroe Islands
| | - T Kold Jensen
- Department of Environmental Medicine, Institute of Public Health, University of Southern Denmark, Odense DK-5000, Denmark; Department of Growth and Reproduction, National Hospital, Copenhagen DK-2100, Denmark
| | - P Grandjean
- Department of Environmental Medicine, Institute of Public Health, University of Southern Denmark, Odense DK-5000, Denmark; Department of Environmental Health, Harvard School of Public Health, Boston, MA 02115, United States
| | - J Halling
- Department of Clinical Pharmacology, University of Southern Denmark, Odense DK-5000, Denmark
| | - M Skaalum Petersen
- Department of Occupational Medicine and Public Health, Faroese Hospital System, Tórshavn FO-110, Faroe Islands
| | - Y Lundberg Giwercman
- Department of Clinical Sciences, Molecular Genetic Reproductive Medicine, Lund University, Malmö 20502, Sweden
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Borgbo T, Jeppesen J, Lindgren I, Lundberg Giwercman Y, Hansen L, Yding Andersen C. Effect of the FSH receptor single nucleotide polymorphisms (FSHR 307/680) on the follicular fluid hormone profile and the granulosa cell gene expression in human small antral follicles. ACTA ACUST UNITED AC 2014; 21:255-61. [DOI: 10.1093/molehr/gau106] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Brokken L, Lundberg P, Spanò M, Manicardi G, Pedersen H, Struciński P, Góralczyk K, Zviezdai V, Jönsson B, Bonde J, Toft G, Lundberg Giwercman Y, Giwercman A. Interactions between polymorphisms in the aryl hydrocarbon receptor signalling pathway and exposure to persistent organochlorine pollutants affect human semen quality. Reprod Toxicol 2014; 49:65-73. [DOI: 10.1016/j.reprotox.2014.07.073] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2014] [Revised: 06/17/2014] [Accepted: 07/21/2014] [Indexed: 11/26/2022]
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Isaksson S, Eberhard J, Ståhl O, Cavallin-Ståhl E, Cohn-Cedermark G, Arver S, Lundberg Giwercman Y, Giwercman A. Inhibin B concentration is predictive for long-term azoospermia in men treated for testicular cancer. Andrology 2014; 2:252-8. [DOI: 10.1111/j.2047-2927.2014.00182.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2013] [Revised: 12/20/2013] [Accepted: 12/28/2013] [Indexed: 01/15/2023]
Affiliation(s)
- S. Isaksson
- Reproductive Medicine Centre; Skåne University Hospital; Malmö Sweden
- Department of Oncology; Skåne University Hospital; Lund Sweden
| | - J. Eberhard
- Department of Oncology; Skåne University Hospital; Lund Sweden
| | - O. Ståhl
- Department of Oncology; Skåne University Hospital; Lund Sweden
| | | | - G. Cohn-Cedermark
- Department of Oncology; Karolinska Institutet and University Hospital; Stockholm Sweden
| | - S. Arver
- Centre for Andrology and Sexual Medicine; Karolinska University Hospital; Stockholm Sweden
- Department of Medicine; Karolinska Institutet; Stockholm Sweden
| | | | - A. Giwercman
- Reproductive Medicine Centre; Skåne University Hospital; Malmö Sweden
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Brokken LJS, Rylander L, Jönsson BA, Spanò M, Pedersen HS, Ludwicki JK, Zviezdai V, Bizzaro D, Manicardi GC, Toft G, Bonde JP, Giwercman A, Lundberg Giwercman Y. Non-linear association between androgen receptor CAG and GGN repeat lengths and reproductive parameters in fertile European and Inuit men. Mol Cell Endocrinol 2013; 370:163-71. [PMID: 23510718 DOI: 10.1016/j.mce.2013.03.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2012] [Revised: 03/01/2013] [Accepted: 03/06/2013] [Indexed: 11/21/2022]
Abstract
Recently the dogma that there is an inverse linear association between androgen receptor (AR) CAG and GGN polymorphisms and receptor activity has been challenged. We analysed the pattern of association between 21 male reproductive phenotypes and AR CAG/GGN repeat lengths in 557 proven-fertile men. A linear association was only found between sperm DNA fragmentation index (DFI) and CAG length, and between inhibin B and GGN length. Men with longer CAG then the reference (22-24), had higher oestradiol levels, whereas men with shorter CAG stretches had a higher DFI and a higher proportion of Fas-positive germ cells. Subjects with either short or long CAG had increased seminal levels of prostate-specific antigen and neutral α-glucosidase activity. Compared to men with the median GGN length of 23, those with shorter GGN repeats had higher levels of inhibin B, higher proportions of normal and progressive sperm, and a higher fraction of Fas-positive sperm, while men with longer GGN had higher oestradiol levels. These data indicate that at least for some markers of male reproductive function the association with CAG or GGN repeat length is curvilinear.
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Affiliation(s)
- L J S Brokken
- Department of Reproductive Molecular Medicine, Lund University, SE-20502 Malmö, Sweden.
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Bobjer J, Naumovska M, Giwercman YL, Giwercman A. High prevalence of androgen deficiency and abnormal lipid profile in infertile men with non-obstructive azoospermia. ACTA ACUST UNITED AC 2012; 35:688-94. [PMID: 22519695 DOI: 10.1111/j.1365-2605.2012.01277.x] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
In men with non-obstructive azoospermia (NOA), the risk of hypogonadism is often overlooked. Testicular sperm extraction (TESE) may increase this risk. The objective of this study was to elucidate the prevalence of hypogonadism in NOA-patients, the impact of TESE on hormone balance and the association between testosterone deficiency and dyslipidaemia. Men with NOA who had undergone TESE during the period 2004-2009 were eligible. Hypogonadism was defined as total testosterone <10 nmol/L and/or LH >10 IU/L and/or ongoing androgen replacement therapy. Sixty-five consecutive men who had undergone TESE owing to NOA and from whom post-TESE serum testosterone levels measured before 1100 h were available. Furthermore, 141 fertile men served as controls. Serum concentrations of testosterone, LH and lipids were assessed. Odds ratios (OR) for biochemical hypogonadism were calculated. Pre- and post-TESE hormone levels were compared. Lipid profile was related to testosterone levels. Hypogonadism was found in 47% (95% CI, 0.36, 0.59) of the NOA-men. As compared with fertile controls, the OR for hypogonadism post-TESE was 17 (95% CI 6.6-45). Serum LH (p = 0.03), but not testosterone (p = 0.43), differed significantly pre- and post-TESE. Compared with eugonadal NOA-men, the OR for having deviations in lipid profile was 3.3 (95% CI 1.3-8.8) for the hypogonadal NOA-men. NOA-men are at very high risk of androgen deficiency, which even in young subjects is associated with dyslipidaemia. Medical management of these men should therefore include endocrinological evaluation and follow-up after completion of infertility treatment.
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Affiliation(s)
- J Bobjer
- Reproductive Medicine Centre, Skåne University Hospital Malmö, Lund University, Malmö, Sweden.
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Romerius P, Ståhl O, Moëll C, Relander T, Cavallin-Ståhl E, Wiebe T, Giwercman YL, Giwercman A. High risk of azoospermia in men treated for childhood cancer. Int J Androl 2011; 34:69-76. [PMID: 20345878 DOI: 10.1111/j.1365-2605.2010.01058.x] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Childhood cancer survivors (CCS) have an increased risk of impaired spermatogenesis, but data regarding the disease- and treatment-related risk factors of azoospermia are scarce. Such information is crucial both for counselling CCS and for selecting patients for testicular tissue cryopreservation. The proportion of azoospermic men in CCS was 18% [95% confidence interval (CI): 12-26], specifically for leukaemias (19%; 95% CI: 5.5-42), Hodgkin's disease (53%; 95% CI: 29-76), non-Hodgkin's lymphoma (11%; 95% CI: 0.28-48) and testicular cancer (11%; 95% CI: 0.28-48). In CCS treated with high doses of alkylating agents, the proportion of azoospermic men was 80% (95% CI: 28-99) and if radiotherapy was used additionally, the proportion was 64% (95% CI: 35-87). In CCS with subnormal Inhibin B levels, the proportion of azoospermic men was 66% (95% CI: 47-81) and for those with elevated follicle-stimulating hormone (FSH) levels, the proportion was 50% (95% CI: 35-67). Among CCS with subnormal testicular volume (≤ 24 mL), azoospermia was found in 61% (95% CI: 39-80) of the cases. Most childhood cancer diagnoses are associated with an increased risk of azoospermia, especially in CCS receiving testicular irradiation, high doses of alkylating drugs and other types of cytotoxic treatment, if combined with irradiation. Inhibin B, FSH and testicular volume can be used as predictors for the risk of azoospermia.
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Affiliation(s)
- P Romerius
- Department of Pediatrics, Lund University Hospital, Lund, Sweden.
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Nenonen HA, Giwercman A, Hallengren E, Giwercman YL. Non-linear association between androgen receptor CAG repeat length and risk of male subfertility--a meta-analysis. ACTA ACUST UNITED AC 2010; 34:327-32. [PMID: 20579136 DOI: 10.1111/j.1365-2605.2010.01084.x] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
The CAG repeat in the androgen receptor (AR) has been widely studied in association with male infertility, but the results are conflicting. In a recent meta-analysis, infertile men had <1 repeat longer CAG stretch than fertile men when analysed in a linear regression model assuming that AR function diminishes with increasing CAG length. However, in vitro, a non-linear activity pattern was recently demonstrated so that ARs containing short and long stretches, respectively, displayed lower activity than the AR of median length. These results prompted us to explore the possible association between CAG number and male infertility risk in a stratified manner on the basis of data from the mentioned meta-analysis and subjects from our clinical unit. The study population included 3915 men, 1831 fertile and 2084 infertile. Data were divided into three categories: CAG<22, CAG 22-23 (reference) and CAG>23 and analysed in a binary logistic regression model. Men with CAG<22 and CAG>23 had 20% increased odds ratio of infertility compared with carriers of the median lengths [for CAG<22: p=0.03, 95% confidence interval (CI): 1.02-1.39; for CAG>23: p=0.02, 95% CI: 1.03-1.44]. These results show that an alternative model to a linear one for the genotype-phenotype association in relation to AR CAG repeats is likely, as lengths close to the median confine lowest risk of infertility.
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Affiliation(s)
- H A Nenonen
- Department of Clinical Sciences, Molecular Genetic Reproductive Medicine, Lund University Reproductive Medicine Centre, Molecular Reproductive Medicine Research Unit, Malmö University Hospital, Lund University, Malmö, Sweden.
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Lundin KB, Giwercman A, Dizeyi N, Giwercman YL. Functional in vitro characterisation of the androgen receptor GGN polymorphism. Mol Cell Endocrinol 2007; 264:184-7. [PMID: 17197074 DOI: 10.1016/j.mce.2006.11.008] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2006] [Revised: 11/29/2006] [Accepted: 11/29/2006] [Indexed: 11/22/2022]
Abstract
Superior androgen receptor (AR) function in subjects carrying a GGN repeat length of 23 (GGN23) has been indicated in vivo. Therefore, the activity of the AR carrying GGN23 combined with CAG22 was compared to the AR with GGN10, 24 and 27, respectively, in the presence of 0.1-100 nM testosterone or DHT. At 100 nM DHT, GGN24 showed 35% lower transactivating activity (95% [CI]: 20-50%) than GGN23. GGN10 and GGN27 also showed significantly less AR activity than GGN23 (mean differences [95% CI]: 54% [40-68%] and 58% [39-78%], respectively). The same trend was also observed at lower DHT concentrations. In response to R1881, GGN23 activity was significantly higher than for other lengths. ARs with other glutamine numbers than 23 have lower transactivating capacity in response to both testosterone and DHT. Congenital malformations and other signs of hypoandrogenism in subjects with AR gene GGN lengths other than 23 could, hence, be related to a lower AR activity.
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Affiliation(s)
- K B Lundin
- Department of Clinical Sciences, Molecular Reproductive Medicine Research Unit, Lund University, Malmö, Sweden
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13
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Tiido T, Rignell-Hydbom A, Jönsson BAG, Rylander L, Giwercman A, Giwercman YL. Modifying effect of the AR gene trinucleotide repeats and SNPs in the AHR and AHRR genes on the association between persistent organohalogen pollutant exposure and human sperm Y : X ratio. Mol Hum Reprod 2007; 13:223-9. [PMID: 17244640 DOI: 10.1093/molehr/gal114] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Persistent organohalogen pollutants (POPs) have been suggested to be involved in changing the proportion of ejaculated Y-bearing sperm. The androgen receptor (AR), aryl hydrocarbon receptor (AHR) and aryl hydrocarbon receptor repressor (AHRR) may modulate the effect of POPs with regard to previously observed sperm Y:X ratio changes. The objective of this study was to investigate whether sperm Y:X ratio changes in subjects exposed to 2,2'4,4'5,5'-hexachlorobiphenyl (CB-153) and dichlorodiphenyl dichloroethene (p,p'-DDE) were modified by polymorphisms in the AR, AHR and AHRR genes. Semen for analysis of Y- and X-bearing sperm by two-colour fluorescence in situ hybridization and blood for leukocyte DNA genotyping and analysis of CB-153 and p,p'-DDE concentrations were obtained from 195 Swedish fishermen. The polymorphic CAG and GGN repeats in the AR and the R554K and P185A single-nucleotide polymorphisms in the AHR and AHRR genes, respectively, were determined by direct sequencing and allele-specific PCR. The effect of p,p'-DDE was modified by CAG or GGN repeat category in relation to the proportion of Y-bearing sperm (P = 0.005 and 0.02 for CAG and GGN, respectively). Moreover, p,p'-DDE, but not CB-153, levels were associated with Y-sperm proportion in men with CAG < 22 (P < 0.001), but not in those carrying CAG > or = 22 (P = 0.73). This association was even more pronounced in subjects carrying a short CAG repeat in combination with an AHRR G-allele. The association in regard to p,p'-DDE was found for GGN = 23 but not for the GGN < 23 or GGN > 23 subgroups (P = 0.01, 0.44 and 0.99, respectively). In conclusion The endocrine-disrupting action of POPs, in relation to the observed changes in sperm Y:X ratio, may be modulated by the genes involved in sex steroid and dioxin-mediated pathways.
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MESH Headings
- Basic Helix-Loop-Helix Transcription Factors
- Chromosomes, Human, X/drug effects
- Chromosomes, Human, Y/drug effects
- Cohort Studies
- Dichlorodiphenyl Dichloroethylene/toxicity
- Environmental Exposure
- Environmental Pollutants/blood
- Environmental Pollutants/toxicity
- Genotype
- Humans
- Hydrocarbons, Chlorinated/blood
- Hydrocarbons, Chlorinated/toxicity
- In Situ Hybridization, Fluorescence
- Male
- Polychlorinated Biphenyls/toxicity
- Polymerase Chain Reaction
- Polymorphism, Single Nucleotide
- Receptors, Androgen/genetics
- Receptors, Androgen/metabolism
- Receptors, Aryl Hydrocarbon/genetics
- Receptors, Aryl Hydrocarbon/metabolism
- Repressor Proteins/genetics
- Repressor Proteins/metabolism
- Spermatogenesis/drug effects
- Spermatozoa/drug effects
- Spermatozoa/metabolism
- Sweden
- Trinucleotide Repeats
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Affiliation(s)
- T Tiido
- Department of Clinical Sciences, Molecular Reproductive Medicine Research Unit, Malmö University Hospital, Sweden.
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14
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Lundin KB, Giwercman YL, Rylander L, Hagmar L, Giwercman A. Androgen receptor gene GGN repeat length and reproductive characteristics in young Swedish men. Eur J Endocrinol 2006; 155:347-54. [PMID: 16868150 DOI: 10.1530/eje.1.02204] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The human androgen receptor (AR) gene contains two polymorphisms of CAG and GGN repeats respectively. The GGN repeat function is still largely unknown and to date there are no in vivo data on this segment with respect to the general population. METHODS We investigated the impact of CAG and GGN repeats on male reproductive function, one by one and in interaction with each other, in 220 adolescent men from the general Swedish population. Physical examination and semen analysis, including accessory sex gland markers and measurement of reproductive hormone levels, were performed. Lifestyle-associated factors, including maternal smoking during pregnancy, were recorded. GGN and CAG repeat lengths were determined by sequencing. RESULTS GGN<23 was associated with lower semen volume when compared to GGN=23 (mean difference -0.6 ml, P=0.02) and GGN>23 (mean difference -0.9 ml, P=0.002). Men with GGN<23, exposed to maternal smoking during pregnancy, had higher body mass index compared to men with other GGN lengths, no matter whether their mother had smoked or not during pregnancy (mean difference 4.8 kg/m2, P<0.001). CONCLUSIONS Short GGN repeats seem to be associated with decreased semen volume, possibly due to suboptimal AR activity. Body composition may be influenced by the combination of fetal exposure to maternal smoking and certain AR genotypes.
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Affiliation(s)
- K B Lundin
- Molecular Reproductive Medicine Research Unit, Department of Clinical Sciences, Lund University, Fertility Centre, Malmö University Hospital, SE-205 02 Malmö, Sweden
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15
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Abstract
Androgens, including 5alpha-dihydrotestosterone (DHT), are known to play a role for spermatogenesis and accessory sex gland function. The enzyme 5alpha-reductase (SRD5A) catalyses the conversion of testosterone to DHT. Our objective was to investigate whether polymorphisms in the SRD5A2 gene influence semen parameters in the general population. DNA from 182 Swedish military conscripts was examined for the A49T, V89L, and R227Q polymorphisms in the SRD5A type 2 gene. Ejaculates were analysed according to WHO guidelines. In addition, sperm motility was assessed using computer-aided sperm analysis (CASA). Seminal markers of epididymal (neutral alpha-glucosidase), prostatic (prostate specific-antigen and zinc), and seminal vesicles function (fructose) were measured. The A49TT-allele was associated with significantly higher sperm concentration compared with the wild type A-allele (mean: 102 x 10(6)/mL vs. 57 x 10(6)/mL, p = 0.02). The V89LV-genotype was correlated with significantly higher proportion progressive motile spermatozoa compared with the L-variant (mean: 55% vs. 48%, p = 0.04). The same trend was found regarding the CASA motile spermatozoa (mean: 52% vs. 41%, p = 0.02). No association between any of the polymorphisms and biochemical markers was found. SRD5A2 gene variants were associated with sperm concentration and motility, but not with epididymal and accessory sex gland markers. This effect on sperm parameters might therefore be exerted via a direct effect of DHT on spermatogenesis.
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Affiliation(s)
- S Elzanaty
- Scanian Andrology Centre, Fertility Centre, Malmö University Hospital, Lund University, Malmö, Sweden.
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Affiliation(s)
- A Giwercman
- Fertility Centre, Department of Urology and Department of Clinical Chemistry, Malmö University Hospital, Lund University, Malmö, Sweden
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17
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Lundin KB, Giwercman A, Richthoff J, Abrahamsson PA, Giwercman YL. No association between mutations in the human androgen receptor GGN repeat and inter-sex conditions. Mol Hum Reprod 2003; 9:375-9. [PMID: 12802043 DOI: 10.1093/molehr/gag048] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The functional role of the GGN repeat in the human androgen receptor gene is unknown, although mutations in this region have been found in patients with inter-sex conditions. We have investigated the prevalence of GGN mutations in the androgen receptor in the Swedish population and their relation to male reproductive function. A physical examination and semen analysis was carried out in 223 men under medical examination before military service and in 94 men referred due to infertility and having sperm concentrations <5 x 10(6)/ml. The GGN and CAG repeats in the androgen receptor gene were directly sequenced. Both populations contained two predominant alleles of 23 and 24 GGN repeats, 83.8 and 90.5% respectively. Four mutations, three in the conscripts and one among the infertile men, were found, resulting in three GGC to GGT substitutions and one GGT to GGC substitution. None of the men presented with genital abnormalities, but two conscripts had low ejaculate volumes (0.3 and 0.9 ml). All men carrying a mutation also had GGN lengths >or=24. Three subjects with GGN >24, with no mutations and with normal seminal volumes, were also found. Our findings indicate that point mutations in the GGN repeat are frequently found in the general male population (1.3%; 95% CI: 0.3-3.9%), but are usually not associated with profound changes in the male phenotype.
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Affiliation(s)
- K B Lundin
- Fertility Centre, Scanian Andrology Centre, Malmö University Hospital, Lund University, Malmö, Sweden.
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18
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Richthoff J, Spano M, Giwercman YL, Frohm B, Jepson K, Malm J, Elzanaty S, Stridsberg M, Giwercman A. The impact of testicular and accessory sex gland function on sperm chromatin integrity as assessed by the sperm chromatin structure assay (SCSA). Hum Reprod 2002; 17:3162-9. [PMID: 12456618 DOI: 10.1093/humrep/17.12.3162] [Citation(s) in RCA: 63] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The sperm chromatin structure assay (SCSA) provides an objective assessment of sperm chromatin integrity, which is essential for normal sperm function. SCSA is valuable as a fertility marker in epidemiological studies and in the clinical situation. Little is known about the impact of testicular and post-testicular function on SCSA parameters. METHODS Ejaculates from 278 military conscripts of median age 18.1 (range 18-21) years were included. Levels of reproductive hormones, the length of the CAG repeat of the androgen receptor gene, sperm concentration, abstinence period and biochemical parameters of epididymal and accessory sex gland secretions were correlated to the SCSA parameters, DNA fragmentation index (DFI) and highly DNA stainable (HDS) cells. RESULTS Negative correlations were found between sperm concentration and DFI (r = -0.119, P = 0.049) and HDS (r = -0.513, P < 0.0001). DFI was negatively correlated with levels of estradiol (r = -0.19, P = 0.002) and free testosterone (r = -0.13, P = 0.03). DFI also correlated positively with abstinence time (r = 0.17, P = 0.005), and with seminal concentrations of fructose (r = 0.18, P = 0.004) and zinc (r = 0.12, P = 0.04). CONCLUSIONS Sex steroid production, spermatogenic function, abstinence time and seminal vesicle function appear to impact on sperm chromatin integrity and thereby on sperm fertilizing capacity. These findings may improve present understanding of the pathophysiology of male infertility.
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Affiliation(s)
- J Richthoff
- Department of Urology, Scanian Andrology Centre (EAA accredited), Malmö University Hospital, Malmö, Sweden
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Giwercman YL, Nikoshkov A, Byström B, Arver S, Wedell A. A novel mutation (N233K) in the transactivating domain and the N756S mutation in the ligand binding domain of the androgen receptor gene are associated with male infertility. Clin Endocrinol (Oxf) 2001; 54:827-34. [PMID: 11422119 DOI: 10.1046/j.1365-2265.2001.01308.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE Resistance to androgens has been suggested as a possible cause of male infertility. This hypothesis is based mainly on binding studies in genital skin fibroblasts but the molecular evidence is sparse. DESIGN Molecular studies of the androgen receptor gene were performed in 10 azoo- or oligozoospermic men, presenting with clinical signs of low androgen activity-poor virilization and high serum LH despite elevated testosterone levels, but without genital malformations. PATIENTS Ten men with serum LH >10 IU/l and testosterone >30 nmol/l as well as a low sperm concentration < 20 x 106/ml. MEASUREMENTS Genomic DNA was prepared from peripheral leucocytes and PCR-amplification of the coding region of androgen receptor was performed, followed by direct sequencing. Identified mutations were reconstructed by site-directed mutagenesis and the functional properties of the mutants were analysed, using transient expression in COS-1 cells and subsequent transactivation assays. Hormone binding assays were performed in genital skin fibroblasts from the patients. RESULTS Two of the 10 men were shown to have a mutation in the androgen receptor gene. Subject 1, who presented with azoospermia, serum testosterone (T) 50 nmol/l and LH 20 IU/l, had a mutation in exon 1, changing amino acid asparagine 233 to lysine (N233K). In fibroblasts cultured from genital skin, the receptor affinity for 5alpha-dihydrotestosterone (DHT) was normal as compared to healthy controls, but the receptor-hormone complex was thermolabile at 42 degrees C. Subject 2 exhibited severe oligozoospermia and a similar endocrine pattern (T = 50 nmol/l and LH = 25 IU/l). He had a mutation in exon 5 changing asparagine 756 to serine (N756S). The affinity for DHT in cultured genital fibroblasts from this patient was reduced. Transactivation was abnormal for both mutants, N233K reaching 46% and N756S 38% of wild type activity when stimulated with 10 nmol/l DHT. CONCLUSIONS Androgen receptor mutations may affect sperm production without resulting in genital malformations. Thus, in infertile men with a clinical presentation of poor androgen activity and an endocrine profile compatible with androgen resistance, mutations in the androgen receptor should be taken into consideration.
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Affiliation(s)
- Y L Giwercman
- Department of Molecular Medicine, Karolinska Hospital, Stockholm, Sweden.
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20
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Lundberg Giwercman Y, Nikoshkov A, Lindsten K, Byström B, Pousette A, Knudtzon J, Alm J, Wedell A. Response to treatment in patients with partial androgen insensitivity due to mutations in the DNA-binding domain of the androgen receptor. Horm Res 2001; 53:83-8. [PMID: 10971094 DOI: 10.1159/000023519] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The androgen insensitivity syndrome is a disorder caused by deficient function of the androgen receptor, characterized by varying degrees of undermasculinization in karyotypic males. We have identified four mutations in the androgen receptor gene, in the region encoding the DNA-binding domain of the protein. Two mutations, R607X and R615G, were found in patients with complete insensitivity to androgens, whereas the other two, S578T and A596T, were found in patients with partial insensitivity. The functional consequences of the three missense mutations were assayed in vitro after transient expression of the receptors in COS cells. All mutants showed normal androgen binding but abnormal abilities to stimulate transcription of an androgen-responsive reporter gene. R615G abolished transactivation whereas S578T and A596T were partially malfunctional. The function of A596T, but not of S578T, was normalized at high androgen concentrations in vitro, reflecting the in vivo situation. Thus, patients with specific mutations in the DNA-binding domain of the androgen receptor may benefit from androgen treatment.
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Giwercman A, Kledal T, Schwartz M, Giwercman YL, Leffers H, Zazzi H, Wedell A, Skakkebaek NE. Preserved male fertility despite decreased androgen sensitivity caused by a mutation in the ligand-binding domain of the androgen receptor gene. J Clin Endocrinol Metab 2000; 85:2253-9. [PMID: 10852459 DOI: 10.1210/jcem.85.6.6626] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Mutations in the androgen receptor gene are considered as incompatible with preservation of fertility and have been suggested as a cause of male infertility. Two adult brothers, referred because of gynecomastia and hormonal levels in serum indicating androgen insensitivity (high sex hormone-binding globulin, and LH levels, despite extremely high testosterone concentration), turned out to be relatives to a third young man, referred independently of the two others and exhibiting identical clinical and hormonal stigmata. In all three men, we found a C-->A substitution at position 2470 (exon 7) in the androgen receptor gene, leading to a Gln824Lys mutation in the ligand-binding domain of the receptor. Exploring the family history revealed that their grandfathers, on their mothers' side, were brothers; and the Gln824Lys mutation was also found in the one of them who was still alive. Binding studies with the mutant receptor in transfected COS-7 cells, with mibolerone as ligand, exhibited equal Kd (0.7 vs. 1.0 nmol/ L), IC50 (0.8 vs. 1.1 nmol/L), and maximum binding (7.1 vs. 8.9 fmol/ 10(6) cells), as compared with the wild-type (WT) receptor. In a chloramphenicol acetyl transferase trans-activation assay, the activity of the mutant receptor was identical to that of the WT, when the synthetic androgen R1881 was'used as a ligand; but with dihydrotestosterone, in concentrations up to 10 nmol/L, the activity of Gln824Lys mutated receptor was 10-62% of the WT variant. Thus, Gln824Lys mutation was found, both in vivo and in vitro, to cause slight impairment of receptor function but was compatible with preservation of male fertility. The patients inherited the mutation from their grandfathers through their mothers, and one of the young men possessing the mutation has fathered a daughter.
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Affiliation(s)
- A Giwercman
- University Department of Growth and Reproduction, Rigshospitalet, Copenhagen, Denmark.
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Giwercman YL, Xu C, Arver S, Pousette A, Reneland R. No association between the androgen receptor gene CAG repeat and impaired sperm production in Swedish men. Clin Genet 1998; 54:435-6. [PMID: 9842998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
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Lundberg Giwercman Y, Nikoshkov A, Lindsten K, Byström B, Pousette A, Chibalin AV, Arvidsson S, Tiulpakov A, Semitcheva TV, Peterkova V, Hagenfeldt K, Ritzén EM, Wedell A. Functional characterisation of mutations in the ligand-binding domain of the androgen receptor gene in patients with androgen insensitivity syndrome. Hum Genet 1998; 103:529-31. [PMID: 9856504 DOI: 10.1007/s004390050864] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Five mutations in the ligand-binding domain of the androgen receptor gene were identified in patients with complete (A765T, C784Y, R831X and M895T) or partial (R840G) androgen insensitivity. A765T and R831X have been reported previously whereas the other three mutations are novel. Receptors carrying these mutations were transiently expressed in COS-1 cells, and androgen binding and capacity to transactivate an androgen-responsive reporter gene were assayed. C784Y led to abolished androgen binding and transactivating capacity, R840G and M895T showed reduced specific binding and partial transactivation. The in vitro functions of the R840G and M895T mutants were improved with supraphysiological concentrations of steroid.
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