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Outcome of testicular sperm extraction in nonmosaic Klinefelter syndrome patients: what is the best approach?
Author(s) -
Majzoub A.,
Arafa M.,
Al Said S.,
Agarwal A.,
Seif A.,
Al Naimi A.,
El Bardisi H.
Publication year - 2016
Publication title -
andrologia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.633
H-Index - 59
eISSN - 1439-0272
pISSN - 0303-4569
DOI - 10.1111/and.12428
Subject(s) - testicular sperm extraction , intracytoplasmic sperm injection , sperm retrieval , medicine , gynecology , infertility , assisted reproductive technology , male infertility , sperm , klinefelter syndrome , azoospermia , retrospective cohort study , andrology , urology , surgery , biology , pregnancy , genetics
Summary Klinefelter syndrome ( KS ) is the most common chromosomal disorder associated with male hypogonadism and infertility. Parenthood can be achieved in men with KS by intracytoplasmic sperm injection ( ICSI ) using testicular spermatozoon. The aim of this study was to evaluate surgical sperm retrieval ( SSR ) rate in patients with KS and to investigate the approach associated with the highest SSR . This is a retrospective study where all medical records of patients with KS who underwent SSR for ICSI , in our centre in the past 14 years, were reviewed. Forty‐three patients were included in this study. Twenty‐three underwent conventional testicular sperm extraction ( TESE ), while 20 patients underwent microsurgical TESE (Micro‐ TESE ). The SSR was significantly higher in the Micro‐ TESE group when compared with the TESE group (30% versus 0% respectively). In the Micro‐ TESE group, hormonal stimulation was given to 16 patients, while no treatment was given to four patients. SSR was only successful in hormonally treated patients (6/16). When the type of hormone stimulation was evaluated, SSR was higher in patients receiving aromatase inhibitors (27.8%). SSR in patients with KS is significantly higher when using hormonal stimulation by aromatase inhibitors followed by microsurgical testicular sperm extraction.