Pericentric inversion of chromosome 9 inv(9) is a common structural variant traditionally considered a benign heterochromatic polymorphism. However, its potential role in reproductive disorders remains controversial. We report a rare case of a 32-year-old male with primary infertility and homozygous inv(9)(p11q13), confirmed through high-resolution Giemsa-Trypsin-Giemsa (GTG) banding. While most literature focuses on heterozygous carriers, homozygous inv(9) cases are sporadic and poorly understood. This case highlights the need for cautious interpretation of cytogenetic findings previously considered benign, especially in the context of idiopathic male infertility. Genetic counseling, molecular diagnostics, and a multidisciplinary approach are essential for accurate assessment and management. Reporting rare variants such as homozygous inv(9) contributes to a broader understanding of their clinical relevance and may inform future reproductive strategies. Although this finding raises the possibility of an association between inv(9) and azoospermia, a causal relationship cannot be established.
Mackic-Djurovic et al. (Mon,) studied this question.