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However, the genetic etiology of OAT is still largely unknown.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To reveal the new genetic factors responsible for male infertility owning to OAT and reveal the outcomes of the affected patients from intracytoplasmic sperm injection (ICSI).<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and methods<\/jats:title><jats:p>Two infertile men with typical OAT were recruited in 2018 and retrospected a cohort that included 47 patients with OAT from 2013 to 2021. Fifty healthy men with proven fertility served as control subjects. To identify the novel pathogenic variants, whole\u2010exome sequencing and Sanger sequencing were used. In silico analysis revealed the affecting of the variants. Field emission scanning electron microscopy was employed to observe the morphological defects of the spermatozoa. Immunofluorescence was used to analyze the expression and localization of the related protein. CRISPR\/Cas9 was used to generate the mouse model. ICSI was used as a treatment for the patients and to assess the effects of the pathogenic variant on fertilization and embryo development.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We identified a loss\u2010of\u2010function mutation NM_001170574.2:c.823G\u00a0&gt;\u00a0T (p.Glu275*) in X\u2010linked <jats:italic>TENT5D<\/jats:italic> from two patients with OAT. This variant is highly deleterious and has not been found in the human population. The count of patients\u2019 spermatozoa is dramatically decreased and displays multiple morphologic abnormalities with poor motility. <jats:italic>Tent5d<\/jats:italic> knockout mice are infertile and exhibit parallel defects. ICSI could rescue the infertility of the <jats:italic>Tent5d<\/jats:italic> knockout male mice. Moreover, the proband was treated with ICSI and achieved a successful pregnancy outcome for the first time. Subsequent mutation screening identified no <jats:italic>TENT5D<\/jats:italic> mutations among 47 additional patients with OAT and 50 control subjects.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Mutation in <jats:italic>TENT5D<\/jats:italic> results in OAT and male infertility, and this terrible situation could be rescued by ICSI.<\/jats:p><\/jats:sec>","DOI":"10.1111\/andr.13407","type":"journal-article","created":{"date-parts":[[2023,2,7]],"date-time":"2023-02-07T00:03:42Z","timestamp":1675728222000},"page":"1121-1131","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["TENT5D disruption causes oligoasthenoteratozoospermia and male infertility"],"prefix":"10.1111","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0321-4915","authenticated-orcid":false,"given":"Yanwei","family":"Sha","sequence":"first","affiliation":[{"name":"Department of Andrology, Women and Children's 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