Reply to Alberto Ferlin`s Letter to the Editor, re: Taylor P. Kohn, Jaden R. Kohn, Ryan C. Owen, R. Matthew Coward. The Prevalence of Y-chromosome Microdeletions in Oligozoospermic Men: A Systematic Review, Meta-analysis of European, North American Studies. Eur Urol 2019, 76:626-36. Indication for Y Chromosome Microdeletion Analysis in Infertile Men Should Not be, Based Merely on Sperm Concentration (European Urology)

It cannot be stressed enough that the whole patient must be considered when determining whether to perform Y-chromosome microdeletion (YCM) testing, and clinicians must first evaluate the patient for other etiologies of infertility with a thorough history, examination, and hormone evaluation [1]. However, when it is determined that men have severe spermatogenic failure, YCM testing should be considered along with a karyotype [2]. Certainly, from the results of our meta-analysis, testing for YCM is of highest yield when sperm concentration is