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Cases  Microdissection testicular sperm extraction (micro‐ TESE ) was performed on five Japanese men with non‐mosaic Klinefelter's syndrome ( KS ) and non‐obstructive azoospermia in the authors' department. Here is reported the operative results and partner's clinical course for two cases where spermatozoa could be acquired. Also encountered was a man with non‐mosaic  KS  with the partial deletion of azoospermia factor ( AZF )b. Because this is rare, it is reported in detail in the context of the previous literature. This case series describes the first experience of micro‐ TESE  by gynecologists in the current department.    Outcome  The egg collection date was adjusted to the micro‐ TESE  day by using the modified ultra‐long method. Intracytoplasmic sperm injection ( ICSI ) was implemented for two men whose spermatozoa were acquired by micro‐ TESE , with these progressing to the blastocyst stage. Subsequently, one case conceived after the transfer of fresh embryos and a healthy baby was delivered. However, spermatozoa could not be retrieved from the man with non‐mosaic  KS  who was harboring the partial deletion of  AZF b.    Conclusion  These findings suggest that ovulation induction by using the modified ultra‐long method with micro‐ TESE  and  ICSI  on the same day represents an effective treatment option for men with non‐mosaic  KS . As there are cases where  AZF  deletion is recognized among patients with non‐mosaic  KS , screening before micro‐ TESE  is strongly recommended.

Microdissection testicular sperm extraction in five Japanese patients with non‐mosaic Klinefelter's syndrome