24-year-old male with no concomitant diseases.
Andrological history: testicular descent at birth, uncircumcised, appearance of normal secondary sexual characteristics at 14 years of age, spermarchia at 14 years of age, sexual debut at 16 years of age, two sexual partners, no history of sexually transmitted diseases. Morning erections 4/7, no problems with voluntary erection, preserved libido, no ejaculatory problems.
Physical examination: Male phenotype without characteristic fascies, no cardiopulmonary alterations, normal breasts in accordance with age and sex. Distribution of android hair, penis with retractile foreskin, central meatus, left testicle with decreased volume compared to the contralateral testicle, of decreased consistency and grade III varicocele; right testicle of normal consistency without clinical evidence of varicocele.
Current condition: infertility of 1 year and a half of evolution, 23-year-old female couple, with fertility study protocol without alterations.
Laboratory: blood biometry: haemoglobin 15.3 g/dl, leucocytes 8,000 cells/µ, PT 13.8 seconds, TTP 28.9 seconds.
Blood chemistry: glucose 80 mg/dl, creatinine 0.96 mg/dl, sodium 142 meq/L, potassium 4.4 meq/L, chlorine 103 meq/L.
General urine examination: pH 6, density 1.020, leucocytes 2-4 per field.
Hormones: LH 5.2 (0.8-7.6 mIU/ml) FSH 12.2 (0.7-11.1 mIU/ml), oestradiol 12.4 (0-56 pg/ml) testosterone 588 ng/dl (270-1734).
Negative urine and semen cultures: negative for Chlamydia, Mycoplasma and Ureaplasma in urethral secretion.
Semen analysis: Normal appearance, normal liquefaction, normal viscosity, volume 3 ml, pH 8.0, concentration 3 million/ml, motility type d=100%.
Morphology (Kruger): normal 0%, abnormal tail 28%, amorphous 36%, ribbed 28%, pin 7%, duplicates 1%.
Oligozoospermia, asthenozoospermia, and severe teratozoospermia.
Scrotal ultrasound: left testicle 4.68 cc with varicocele, right testicle 10.92 cc, both epididymides normal.
Karyotype: 46,XY.
Y chromosome microdeletions by multiplex polymerase chain reaction technique of STS Y chromosome:
Multiplex A:
ZFY, SRY, sY84 (AZFa) present.
sY254 (AZFc), sY127 (AZFb) absent.
Multiplex B:
ZFY, SRY, sY86(AZFa) present.
sY134 (AZFb), sY255 (AZFc) absent.
Analyses were performed in triplicate and positive and negative controls were taken as reference.

