[Downloaded free from http://www.jhrsonline.org on Tuesday, May 15, 2012, IP: 80.191.92.211] || Click here to download free Android application for this journal Address for correspondence: Dr. Dilip Gude, AMC, 3rd Floor, Medwin Hospital, Chirag Ali Lane, Nampally, Hyderabad - 500 001, Andhra Pradesh, India. E-mail: letsgo.dilip@gmail.com REFERENCES 1. 2. 3. 4. 5. Chiu PC, Wong BS, Lee CL, Lam KK, Chung MK, Lee KF, et al. Zona pellucida-induced acrosome reaction in human spermatozoa is potentiated by glycodelin-A via down-regulation of extracellular signal-regulated kinases and up-regulation of zona pellucida-induced calcium influx. Hum Reprod 2010;25:2721-33. Bentin-Ley U, Lindhard A, Ravn V, Islin H, Sørensen S. Glycodelin in endometrial flushing fluid and endometrial biopsies from infertile and fertile women. Eur J Obstet Gynecol Reprod Biol 2011;156:60-6. Lam KK, Chiu PC, Chung MK, Lee CL, Lee KF, Koistinen R, et al. Glycodelin-A as a modulator of trophoblast invasion. Hum Reprod 2009;24:2093-103. Lee CL, Lam KK, Koistinen H, Seppala M, Kurpisz M, Fernandez N, et al. Glycodelin-A as a paracrine regulator in early pregnancy. J Reprod Immunol 2011;90:29-34. Zizzi A, Lucarini G, Stramazzotti D, Ciavattini A, Goteri G. Glycodelin and p16 expression in cervical intraepithelial neoplastic lesions: Differences between pregnant and non-pregnant patients. Ital J Anat Embryol 2010;115:83. The two markers sY254 and sY255 are speciic for the human DAZ genes, which is present in four copies arranged in two clusters, each comprising an inverted pair of DAZ genes.[2] The absence of both STSs indicates the deletion of the entire AZFc region, which removes all copies of the DAZ genes. According to current knowledge, the deletion of only one of these two STSs is impossible and should be always regarded as a methodological mistake. The deletion of individual copies of the DAZ genes is possible but cannot be detected with PCR or multiplex PCR.[3] For the detection of Y chromosome microdeletions in AZFa, AZFb, and AZFc regions, there are validated guidelines endorsed by the European Academy of Andrology (EAA) and the European Molecular Genetics Quality Network (EMQN).[3] This protocol could detect up to 95% of all reported AZF microdeletions;[3] however, Malekasgar and Mombaini did not use this guideline in the screening of infertile men in South of Iran. Kioomars Saliminejad1, Hamid Reza Khorram Khorshid1,2 1 Department of Reproductive Genetics and Biotechnology, Reproductive Biotechnology Research Center, Avicenna Research Institute, ACECR, 2Genetic Research Center, University of Social Welfare and Rehabilitation Science, Tehran, Iran Address for correspondence: Mr. Kioomars Saliminejad, Avicenna Research Institute, Shahid Beheshti University, PO Box 19615-1177, Evin, Tehran, Iran. E-mail: kioomars77@yahoo.com Access this article online Quick Response Code: Website: www.jhrsonline.org DOI: 10.4103/0974-1208.92294 REFERENCES 1. 2. Discrepancy in the results of Y chromosome microdeletions in an Iranian population 3. Malekasgar AM, Mombaini H. Screening of Y chromosome microdeletions in Iranian infertile males. J Hum Reprod Sci 2008;1:2-9. Saxena R, de Vries JW, Repping S, Alagappan RK, Skaletsky H, Brown LG, et al. Four DAZ genes in two clusters found in the AZFc region of the human Y chromosome. Genomics 2000;67:256-67. Simoni M, Bakker E, Krausz C. EAA/EMQN best practice guidelines for molecular diagnosis of y-chromosomal microdeletions. State of the art 2004. Int J Androl 2004;27:240-9. Access this article online Quick Response Code: Website: www.jhrsonline.org DOI: Sir, A few studies of the Y chromosome microdeletions have been performed among Iranian infertile males. Because of the high frequency of microdeletions of the Y chromosome reported by Malekasgar and Mombaini,[1] we reviewed with a great interest the related paper. They found microdeletions in 51.6% (16/31) of azoospermic patients and 52.6% (10/19) of severe oligozoospermic men in South of Iran.[1] According to their results, the incidence of Y microdeletions was much higher than the reported frequency in other countries. They reported four azoo/oligozoospermic patients with the deletion of only one of the two markers sY254 or sY255 in these men.[1] 10.4103/0974-1208.92295 Authors’ reply Sir, This reply is in response to the leter I received.[1] Some points worth mentioning are as follows: 1. We have not reported microdeletions in 51.6% of azoospermic and 52.6% of severe oligozoospermic men Journal of Human Reproductive Sciences / Volume 4 / Issue 3 / Sep - Dec 2011 157 [Downloaded free from http://www.jhrsonline.org on Tuesday, May 15, 2012, IP: 80.191.92.211] || Click here to download free Android application for this journal Letters to Editor as they claim. Instead, we have reported 52% (26 persons) of patients (including azospermics and oligospermics men) with microdeletions. Of these 26 patients with microdeletions, 16 (61.5%) azoospermics and 10 (38.5%) oligozoospermics were recorded.[2] 2. Only 3 persons (patient number 11, 30, and 34) had deletion in sY254. Of these 3 patients, 1 (number 34) had deletion with six other STS markers including sY255. Therefore, only 2 patients had deletion in sY254 and normal with sY255. What our colleagues claim in their leter is true, but the reason behind this could be polymorphism or mistake in reading or performing the test for those 2 patients. might seem that this simple technique can be a good tool for a resource-limited seting. However, there are some concerns in laboratory medicine. In a previous publication, it was well demonstrated that “the post-glucose load GI ratio cannot be used to determine the magnitude of insulin resistance.”[2] The positive inding in the present work might be by chance or due to the small number of studied subjects or uncontrolled confounding factors. Somsri Wiwanitkit, Viroj Wiwanitkit Wiwanitkit House, Bangkhae, Bangkok, Thailand Address for correspondence: Dr. Somsri Wiwanitkit, Wiwanitkit House, Bangkhae, Bangkok 10160, Thailand. E-mail: somsriwiwan@hotmail.com Ali Mohammad Malekasgar, Hayat Mombaini Department of Medical Science, Genetic Unit, Qom University of Medical Sciences, Iran Address for correspondence: Dr. Ali Mohammad Malekasgar, Department of Medical Science, Genetic Unit, Qom University of Medical Sciences, Iran. E-mail: malekasgar@yahoo.co.uk REFERENCES 1. 2. Saliminejad K, Khorshid HRK. Discrepancy in the results of Y chromosome microdeletions in an Iranian population. J Hum Reprod Sci 2011;4:157. Malekasgar AM, Mombaini H. Screening of Y chromosome microdeletions in Iranian infertile males. J Hum Reprod Sci 2008;1:2-9. REFERENCES 1. 2. Saxena P, Prakash A, Nigam A. Efficacy of 2-hour post glucose insulin levels in predicting insulin resistance in polycystic ovarian syndrome with infertility. J Hum Reprod Sci 2011;4:20-2. Dahan MH, Goldstein J. Serum sex hormone-binding globulin levels show too much variability to be used effectively as a screening marker for insulin resistance in women with polycystic ovary syndrome. Fertil Steril 2006;86:934-41. Access this article online Quick Response Code: Website: www.jhrsonline.org DOI: Access this article online 10.4103/0974-1208.92297 Quick Response Code: Website: www.jhrsonline.org Post‑glucose insulin level in polycystic ovarian syndrome Sir, The recent report on the post-glucose insulin level in polycystic ovarian syndrome is very interesting. [1] In this work, the insulin resistance prediction by the 2-h post-glucose insulin level was studied. Saxena et al. concluded that the “2-h post-glucose insulin level appears to be a good indicator of IR. It can be a useful tool.”[1] It 158 Authors’ reply We are grateful to Wiwanitkit S and Wiwanitkit V[1] for their interest in the indings of our study.[2] The study by Dahan MH et al.,[3] was based in Washington University Reproductive Centre and though the race has not been mentioned, it is likely that ethnic variations and inclusion of patients with variable body mass index in their study may be responsible for the diferent results observed between the studies. Moreover, the study of Dahan et al. had aimed to study serum sex-hormone binding globulin (SHBG) levels in relation to insulin resistance parameters. They themselves have stated that polycystic ovarian syndrome (PCOS) and lean controls demonstrated diferent glucose and insulin responses to 75 gram glucose load as has been seen in our study too. Despite this diference their study showed paradoxically similar GI ratios, a paradox which even the authors were unable to explain. Possibly the smaller sample size of 19 PCOS and 17 controls, adding to chance negative inding and uncontrolled confounding factors Journal of Human Reproductive Sciences / Volume 4 / Issue 3 / Sep - Dec 2011