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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">medgen</journal-id><journal-title-group><journal-title xml:lang="ru">Медицинская генетика</journal-title><trans-title-group xml:lang="en"><trans-title>Medical Genetics</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2073-7998</issn><publisher><publisher-name>Publishing House «Genius Media» LLC</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.25557/2073-7998.2021.05.34-40</article-id><article-id custom-type="elpub" pub-id-type="custom">medgen-1910</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>ORIGINAL RESEARCH</subject></subj-group></article-categories><title-group><article-title>Оценка влияния CFTR-генотипа на сперматологические показатели у пациентов с синдромом CBAVD</article-title><trans-title-group xml:lang="en"><trans-title>An influence of the CFTR genotype on semen parameters in CBAVD syndrome patients</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Марнат</surname><given-names>Е. Г.</given-names></name><name name-style="western" xml:lang="en"><surname>Marnat</surname><given-names>E. G.</given-names></name></name-alternatives><email xlink:type="simple">noemail@neicon.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Сорокина</surname><given-names>Т. М.</given-names></name><name name-style="western" xml:lang="en"><surname>Sorokina</surname><given-names>T. M.</given-names></name></name-alternatives><email xlink:type="simple">noemail@neicon.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Штаут</surname><given-names>М. И.</given-names></name><name name-style="western" xml:lang="en"><surname>Shtaut</surname><given-names>M. I.</given-names></name></name-alternatives><email xlink:type="simple">noemail@neicon.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Седова</surname><given-names>А. О.</given-names></name><name name-style="western" xml:lang="en"><surname>Sedova</surname><given-names>A. O.</given-names></name></name-alternatives><email xlink:type="simple">noemail@neicon.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Адян</surname><given-names>Т. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Adyan</surname><given-names>T. A.</given-names></name></name-alternatives><email xlink:type="simple">noemail@neicon.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Степанова</surname><given-names>А. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Stepanova</surname><given-names>A. A.</given-names></name></name-alternatives><email xlink:type="simple">noemail@neicon.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Бескоровайная</surname><given-names>Т. С.</given-names></name><name name-style="western" xml:lang="en"><surname>Beskorovaynaya</surname><given-names>T. S.</given-names></name></name-alternatives><email xlink:type="simple">noemail@neicon.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Поляков</surname><given-names>А. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Polyakov</surname><given-names>A. V.</given-names></name></name-alternatives><email xlink:type="simple">noemail@neicon.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Курило</surname><given-names>Л. Ф.</given-names></name><name name-style="western" xml:lang="en"><surname>Kurilo</surname><given-names>L. F.</given-names></name></name-alternatives><email xlink:type="simple">noemail@neicon.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Черных</surname><given-names>В. Б.</given-names></name><name name-style="western" xml:lang="en"><surname>Chernykh</surname><given-names>V. B.</given-names></name></name-alternatives><email xlink:type="simple">chernykh@med-gen.ru</email><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>ФГБНУ «Медико-генетический научный центр имени академика Н.П. Бочкова»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Research Centre for Medical Genetics</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2021</year></pub-date><pub-date pub-type="epub"><day>04</day><month>08</month><year>2021</year></pub-date><volume>20</volume><issue>5</issue><fpage>34</fpage><lpage>40</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Марнат Е.Г., Сорокина Т.М., Штаут М.И., Седова А.О., Адян Т.А., Степанова А.А., Бескоровайная Т.С., Поляков А.В., Курило Л.Ф., Черных В.Б., 2021</copyright-statement><copyright-year>2021</copyright-year><copyright-holder xml:lang="ru">Марнат Е.Г., Сорокина Т.М., Штаут М.И., Седова А.О., Адян Т.А., Степанова А.А., Бескоровайная Т.С., Поляков А.В., Курило Л.Ф., Черных В.Б.</copyright-holder><copyright-holder xml:lang="en">Marnat E.G., Sorokina T.M., Shtaut M.I., Sedova A.O., Adyan T.A., Stepanova A.A., Beskorovaynaya T.S., Polyakov A.V., Kurilo L.F., Chernykh V.B.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.medgen-journal.ru/jour/article/view/1910">https://www.medgen-journal.ru/jour/article/view/1910</self-uri><abstract><p>Синдром CBAVD (congenital bilateral aplasia of vas deferens) - двухсторонняя врожденная аплазия семявыносящих протоков, которая является основной генетической причиной мужского бесплодия, связанного с обструктивной азооспермией. CBAVD имеет гетерогенную природу, в большинстве случаев вызван патогенными вариантами в гене CFTR, редкими его причинами могут быть мутации в других генах. Хотя фенотипическая вариабельность врожденной аплазии семявыносящих путей описана, в том числе ее морфологические варианты, влияние генотипа на состояние половых органов и показатели эякулята у пациентов с синдромом CBAVD недостаточно исследовано. Цель: оценить влияние генотипа гена CFTR на сперматологические показатели у пациентов с синдромом CBAVD. Обследована группа из 74 неродственных российских мужчин репродуктивного возраста с синдромом CBAVD. Молекулярно-генетический анализ включал поиск 22 наиболее распространенных патогенных вариантов гена CFTR в РФ, а также полиморфного локуса IVS8-Tn в интроне 8. Всем пациентам проведено спермиологическое исследование. Патогенные варианты гена CFTR обнаружены на 51 из 148 (34,5%) исследованных аллелей. Наличие аллельного варианта IVS-T5 (5Т) выявлено в 43 из 148 (29,1%) аллелей. Проведен сравнительный анализ двух групп пациентов с патогенными вариантами и/или 5Т аллелем гена CFTR (группа I) и без них (группа II). У 62 из 74 (83,7%) пациентов обнаружена азооспермия, у 12 (16,3%) - криптозооспермия/олигозооспермия тяжелой степени. Олигоспермия (объём эякулята менее 1,5 мл) обнаружена в группах I и II у 56 из 61 (91,8%) и 12 из 13 (92,3%) пациентов, соответственно. Повышенная вязкость отмечена в образцах эякулята у 4 (6,6%) пациентов группы I и 5 (38,5%) пациентов группы II. Лейкоспермия обнаружена только в группе II у 3 (4,1%) пациентов. Между этими группами не выявлено статистически значимых различий по объему, вязкости и рН эякулята, количеству сперматозоидов и лейкоцитов. Полученные данные свидетельствуют, что генотип по гену CFTR не оказывает значимого влияния на сперматологические параметры пациентов с синдромом CBAVD.</p></abstract><trans-abstract xml:lang="en"><p>CBAVD syndrome (congenital bilateral aplasia of vas deferens) is a bilateral congenital aplasia of the VAS deferens, which is the main genetic cause of male infertility associated with obstructive azoospermia. CBAVD is heterogeneous in nature, in most cases, it is caused by pathogenic variants in the CFTR gene, mutations in other genes can be a rare cause. Although the phenotypic variability of congenital VAS deferens aplasia has been shown, including its morphological variants, the effect of the genotype on the state of the genitals and ejaculate parameters in patients with CBAVD syndrome has not been sufficiently studied. Aim: to evaluate the effect of the CFTR genotype on semen parameters in CBAVD syndrome patients. Materials and methods: a group of 74 unrelated Russian men of reproductive age with a diagnosis of CBAVD syndrome was examined. Molecular genetic analysis included the detection for 22 common pathogenic variants of the CFTR gene, and the IVS8-Tn polymorphic locus in intron 8. Semen analysis was performed in all patients. Results: Pathogenic variants of the CFTR gene were found in 51 of 148 (34,5%) alleles, IVS-T5 (5T) allele variant was revealed in 43 of 148 (29.1%) alleles. A comparative analysis of two groups of patients with pathogenic variants of the CFTR gene (group I) and without them (group II) was performed. Azoospermia was diagnosed in 62 of 74 (83.7%) patients, cryptozoospermia/severe oligozoospermia - in 12 (16.3%) patients. Oligospermia (ejaculate volume less than 1.5 ml) was found in groups I and II in 56 of 61 (91.8%) and 12 of 13 (92.3%) patients, respectively. Increased viscosity was observed in ejaculate samples in 4 (6.6%) patients of group I and 5 (38.5%) patients of group II. Leukospermia was found only in group II, in 3 (4.1%) patients. There were no statistically significant differences in semen parameters between the groups. Obtained data indicate that the CFTR genotype does not significantly affect semen parameters in CBAVD syndrome patients.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>ген CFTR</kwd><kwd>синдром CBAVD</kwd><kwd>мужское бесплодие</kwd><kwd>азооспермия</kwd></kwd-group><kwd-group xml:lang="en"><kwd>CFTR gene</kwd><kwd>CBAVD syndrome</kwd><kwd>male infertility</kwd><kwd>azoospermia</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Claustres M. Molecular pathology of the CFTR locus in male infertility. Reprod Biomed Online. 2005; 10 (1): 14-41.</mixed-citation><mixed-citation xml:lang="en">Claustres M. Molecular pathology of the CFTR locus in male infertility. Reprod Biomed Online. 2005; 10 (1): 14-41.</mixed-citation></citation-alternatives></ref><ref id="cit2"><label>2</label><citation-alternatives><mixed-citation xml:lang="ru">Anguiano A., Oates R.D., Amos J.A. et al. Congenital bilateral absence of the vas deferens. A primarily genital form of cystic fibrosis. JAMA. 1992; 267: 1794-1797.</mixed-citation><mixed-citation xml:lang="en">Anguiano A., Oates R.D., Amos J.A. et al. Congenital bilateral absence of the vas deferens. A primarily genital form of cystic fibrosis. JAMA. 1992; 267: 1794-1797.</mixed-citation></citation-alternatives></ref><ref id="cit3"><label>3</label><citation-alternatives><mixed-citation xml:lang="ru">Chillon M., Casals Т., Mercier B. et al. Mutations in the cystic fibrosis gene in patients with congenital absence of the vas deferens. New Eng. J. Med. 1995; 332 (22):1475-1480.</mixed-citation><mixed-citation xml:lang="en">Chillon M., Casals Т., Mercier B. et al. Mutations in the cystic fibrosis gene in patients with congenital absence of the vas deferens. New Eng. J. Med. 1995; 332 (22):1475-1480.</mixed-citation></citation-alternatives></ref><ref id="cit4"><label>4</label><citation-alternatives><mixed-citation xml:lang="ru">Schwiebert E.M., Benos D.J., Egan M.E. et al. CFTR is a conductance regulator as well as a chloride channel. Physiol. Rev. 1999; 79(S 1): S145-S166.</mixed-citation><mixed-citation xml:lang="en">Schwiebert E.M., Benos D.J., Egan M.E. et al. CFTR is a conductance regulator as well as a chloride channel. Physiol. Rev. 1999; 79(S 1): S145-S166.</mixed-citation></citation-alternatives></ref><ref id="cit5"><label>5</label><citation-alternatives><mixed-citation xml:lang="ru">Braekeleer M., Ferec C. Mutations in the cystic fibrosis gene in men with congenital bilateral absence of the vas deferens. Mol. Hum. Reprod. 1996; 2: 669-677.</mixed-citation><mixed-citation xml:lang="en">Braekeleer M., Ferec C. Mutations in the cystic fibrosis gene in men with congenital bilateral absence of the vas deferens. Mol. Hum. Reprod. 1996; 2: 669-677.</mixed-citation></citation-alternatives></ref><ref id="cit6"><label>6</label><citation-alternatives><mixed-citation xml:lang="ru">Dork Т., Dworniczak В., Aulehla Scholz C. et al. Distinct spectrum of CFTR gene mutations in congenital absence of vas deferens. Hum. Genet. 1997; 100: 365-377.</mixed-citation><mixed-citation xml:lang="en">Dork Т., Dworniczak В., Aulehla Scholz C. et al. Distinct spectrum of CFTR gene mutations in congenital absence of vas deferens. Hum. Genet. 1997; 100: 365-377.</mixed-citation></citation-alternatives></ref><ref id="cit7"><label>7</label><citation-alternatives><mixed-citation xml:lang="ru">Claustres M., Guittard C., Bozon D. et al. Spectrum of CFTR mutations in cystic fibrosis and in congenital absence of the vas deferens in France. Hum. Mutat. 2000; 16: 143-156.</mixed-citation><mixed-citation xml:lang="en">Claustres M., Guittard C., Bozon D. et al. Spectrum of CFTR mutations in cystic fibrosis and in congenital absence of the vas deferens in France. Hum. Mutat. 2000; 16: 143-156.</mixed-citation></citation-alternatives></ref><ref id="cit8"><label>8</label><citation-alternatives><mixed-citation xml:lang="ru">Bieth E., Hamdi S.M., Mieusset R. Genetics of the congenital absence of the vas deferens. Hum Genet. 2021 Jan;140(1):59-76. doi: 10.1007/s00439-020-02122-w.</mixed-citation><mixed-citation xml:lang="en">Bieth E., Hamdi S.M., Mieusset R. Genetics of the congenital absence of the vas deferens. Hum Genet. 2021 Jan;140(1):59-76. doi: 10.1007/s00439-020-02122-w.</mixed-citation></citation-alternatives></ref><ref id="cit9"><label>9</label><citation-alternatives><mixed-citation xml:lang="ru">Руководство ВОЗ по исследованию и обработке эякулята человека. Пер. с англ. Макарова Н.П. Науч. ред. Курило Л.Ф. 5-е изд. М.: Капитал Принт, 2012. 291 с.</mixed-citation><mixed-citation xml:lang="en">Руководство ВОЗ по исследованию и обработке эякулята человека. Пер. с англ. Макарова Н.П. Науч. ред. Курило Л.Ф. 5-е изд. М.: Капитал Принт, 2012. 291 с.</mixed-citation></citation-alternatives></ref><ref id="cit10"><label>10</label><citation-alternatives><mixed-citation xml:lang="ru">Черных В.Б., Степанова А.А, Бескоровайная Т.С. и др. Частота и спектр мутаций и IVS8-T-полиморфизма гена CFTR среди российских мужчин с бесплодием. Генетика. 2010; 46(6):. 844-852.</mixed-citation><mixed-citation xml:lang="en">Черных В.Б., Степанова А.А, Бескоровайная Т.С. и др. Частота и спектр мутаций и IVS8-T-полиморфизма гена CFTR среди российских мужчин с бесплодием. Генетика. 2010; 46(6):. 844-852.</mixed-citation></citation-alternatives></ref><ref id="cit11"><label>11</label><citation-alternatives><mixed-citation xml:lang="ru">Chiang H., Lu J., Liu C., Wu Y., Wu C. CFTR (TG)m(T)n polymorphism in patients with CBAVD in a population expressing low incidence of cystic fibrosis. Clin. Genet. 2009; 76:282-286.</mixed-citation><mixed-citation xml:lang="en">Chiang H., Lu J., Liu C., Wu Y., Wu C. CFTR (TG)m(T)n polymorphism in patients with CBAVD in a population expressing low incidence of cystic fibrosis. Clin. Genet. 2009; 76:282-286.</mixed-citation></citation-alternatives></ref><ref id="cit12"><label>12</label><citation-alternatives><mixed-citation xml:lang="ru">Casals T., Bassas L., Egozcue S. et al. Heterogeneity for mutations in the CFTR gene and clinical correlations in patients with congenital absence of the vas deferens. Hum. Reprod. 2000 Jul;15(7):1476-83.</mixed-citation><mixed-citation xml:lang="en">Casals T., Bassas L., Egozcue S. et al. Heterogeneity for mutations in the CFTR gene and clinical correlations in patients with congenital absence of the vas deferens. Hum. Reprod. 2000 Jul;15(7):1476-83.</mixed-citation></citation-alternatives></ref><ref id="cit13"><label>13</label><citation-alternatives><mixed-citation xml:lang="ru">Штаут М.И., Сорокина Т.М., Курило Л.Ф., Шмарина Г.В., Марнат Е.Г., Репина С.А., Красовский С.А., Черных В.Б. Сравнительный анализ результатов спермиологического исследования у пациентов с азооспермией, вызванной муковисцидозом и синдромом врожденной двусторонней аплазии семявыносящих протоков. Андрология и генитальная хирургия. 2019;20(1):82-90. https:doi.org/10.17650/2070-9781-2019-20-1-82-90</mixed-citation><mixed-citation xml:lang="en">Штаут М.И., Сорокина Т.М., Курило Л.Ф., Шмарина Г.В., Марнат Е.Г., Репина С.А., Красовский С.А., Черных В.Б. Сравнительный анализ результатов спермиологического исследования у пациентов с азооспермией, вызванной муковисцидозом и синдромом врожденной двусторонней аплазии семявыносящих протоков. Андрология и генитальная хирургия. 2019;20(1):82-90. https:doi.org/10.17650/2070-9781-2019-20-1-82-90</mixed-citation></citation-alternatives></ref><ref id="cit14"><label>14</label><citation-alternatives><mixed-citation xml:lang="ru">Wu C.C., Hsieh-Li H.M., Lin Y.M. et al. Cystic fibrosis transmembrane conductance regulator gene screening and clinical correlation in Taiwanese males with congenital bilateral absence of the vas deferens. Hum Reprod. 2004; 19 (2): 250-253.</mixed-citation><mixed-citation xml:lang="en">Wu C.C., Hsieh-Li H.M., Lin Y.M. et al. Cystic fibrosis transmembrane conductance regulator gene screening and clinical correlation in Taiwanese males with congenital bilateral absence of the vas deferens. Hum Reprod. 2004; 19 (2): 250-253.</mixed-citation></citation-alternatives></ref><ref id="cit15"><label>15</label><citation-alternatives><mixed-citation xml:lang="ru">Sharma N., Acharya N., Singh S.K., et al. Heterogenous spectrum of CFTR gene mutations in Indian patients with congenital absence of vas deferens. Hum Reprod. 2009; 24 (5): 1229-1236. doi 10.1093/humrep/den500</mixed-citation><mixed-citation xml:lang="en">Sharma N., Acharya N., Singh S.K., et al. Heterogenous spectrum of CFTR gene mutations in Indian patients with congenital absence of vas deferens. Hum Reprod. 2009; 24 (5): 1229-1236. doi 10.1093/humrep/den500</mixed-citation></citation-alternatives></ref><ref id="cit16"><label>16</label><citation-alternatives><mixed-citation xml:lang="ru">Li H., Wen Q., Zhao L. et al. Mutations in the cystic fibrosis transmembrane conductance regulator (CFTR) in Chinese patients with congenital bilateral absence of vas deferens. J Cyst Fibros. 2012 Jul;11(4):316-23. doi 10.1016/j.jcf.2012.01.005</mixed-citation><mixed-citation xml:lang="en">Li H., Wen Q., Zhao L. et al. Mutations in the cystic fibrosis transmembrane conductance regulator (CFTR) in Chinese patients with congenital bilateral absence of vas deferens. J Cyst Fibros. 2012 Jul;11(4):316-23. doi 10.1016/j.jcf.2012.01.005</mixed-citation></citation-alternatives></ref><ref id="cit17"><label>17</label><citation-alternatives><mixed-citation xml:lang="ru">Yang B., Wang J., Zhang W. et al. Pathogenic role of ADGRG2 in CBAVD patients replicated in Chinese population. Andrology. 2017; 5:954-957.</mixed-citation><mixed-citation xml:lang="en">Yang B., Wang J., Zhang W. et al. Pathogenic role of ADGRG2 in CBAVD patients replicated in Chinese population. Andrology. 2017; 5:954-957.</mixed-citation></citation-alternatives></ref><ref id="cit18"><label>18</label><citation-alternatives><mixed-citation xml:lang="ru">Patat O., Pagin A., Siegfried A. et al. Truncating Mutations in the Adhesion G Protein-coupled receptor G2 gene ADGRG2 cause an X-Linked congenital bilateral absence of vas deferens. Am J Hum Genet. 2016; 99(2): 437-442.</mixed-citation><mixed-citation xml:lang="en">Patat O., Pagin A., Siegfried A. et al. Truncating Mutations in the Adhesion G Protein-coupled receptor G2 gene ADGRG2 cause an X-Linked congenital bilateral absence of vas deferens. Am J Hum Genet. 2016; 99(2): 437-442.</mixed-citation></citation-alternatives></ref><ref id="cit19"><label>19</label><citation-alternatives><mixed-citation xml:lang="ru">Chiang H.S., Wang Y.Y., Lin Y.H., Wu Y.N. The role of SLC9A3 in Taiwanese patients with congenital bilateral absence of vas deferens (CBAVD). J Formos Med Assoc. 2019 Dec; 118(12):1576-1583.</mixed-citation><mixed-citation xml:lang="en">Chiang H.S., Wang Y.Y., Lin Y.H., Wu Y.N. The role of SLC9A3 in Taiwanese patients with congenital bilateral absence of vas deferens (CBAVD). J Formos Med Assoc. 2019 Dec; 118(12):1576-1583.</mixed-citation></citation-alternatives></ref><ref id="cit20"><label>20</label><citation-alternatives><mixed-citation xml:lang="ru">Von Eckardstein S., Cooper T.G., Rutscha K., Meschede D., Horst J., Nieschlag E. Seminal plasma characteristics as indicators of cystic fibrosis transmembrane conductance regulator (CFTR) gene mutations in men with obstructive azoospermia. Fertil Steril. 2000 Jun; 73(6):1226-31. doi: 10.1016/s0015-0282(00)00516-1.</mixed-citation><mixed-citation xml:lang="en">Von Eckardstein S., Cooper T.G., Rutscha K., Meschede D., Horst J., Nieschlag E. Seminal plasma characteristics as indicators of cystic fibrosis transmembrane conductance regulator (CFTR) gene mutations in men with obstructive azoospermia. Fertil Steril. 2000 Jun; 73(6):1226-31. doi: 10.1016/s0015-0282(00)00516-1.</mixed-citation></citation-alternatives></ref></ref-list><fn-group><fn fn-type="conflict"><p>The authors declare that there are no conflicts of interest present.</p></fn></fn-group></back></article>
