Aging may adversely affect testicular sperm recovery in patients with Klinefelter syndrome

Bakırcıoğlu, Emre; Erden, Halit Firat; Kaplancan, Tansel; Ciray, H. Nadir; Bener, Faruk; Bahçeci, Mustafa

doi:10.1016/j.urology.2006.05.028

Cited by 77 publications

(48 citation statements)

References 19 publications

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“…Several authors demonstrated that age at TESE might affect the outcome of TESE in Klinefelter patients (Table 1) (66,67,69,70,73). This is in accordance with the concept of a progressive degradation of the spermatogonia, and based on single case reports, declining spermatogenesis with ageing in Klinefelter men has been reported (9,10).…”

Section: Predictive Factors Of Successful Tese In 47xxysupporting

confidence: 71%

Therapy of endocrine disease: Testicular function and fertility in men with Klinefelter syndrome: a review

Aksglæde

Juul

2013

European Journal of Endocrinology

175

114

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Klinefelter syndrome, 47,XXY (KS), is the most frequent sex chromosome aberration in males, affecting 1 in 660 newborn boys. The syndrome is characterized by testicular destruction with extensive fibrosis and hyalinization of the seminiferous tubules resulting in small testes, hypergonadotropic hypogonadism, and azoospermia in the majority of cases. Until recently, infertility was considered an untreatable condition in KS. However, with the development of new advanced assisted reproductive techniques such as testicular sperm extraction (TESE) combined with ICSI it seems that KS patients should no longer be labelled as infertile. Especially, microdissection (micro)-TESE has proved to be an advantageous procedure for the identification of testicular spermatozoa in KS. The aim of this review was to describe current knowledge on the testicular changes occurring in KS, the associated changes in reproductive hormones and spermatogenesis, and the existing possibilities of biological fatherhood in 47,XXY patients. European Journal of Endocrinology 168 R67-R76

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Section: Predictive Factors Of Successful Tese In 47xxysupporting

confidence: 71%

Therapy of endocrine disease: Testicular function and fertility in men with Klinefelter syndrome: a review

Aksglæde

Juul

2013

European Journal of Endocrinology

175

114

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“…Furthermore, it is also associated with the various aspects of life in these patients (Bak et al, 2012). In addition, age has been found to be an important factor for testicular sperm recovery and successful sperm retrieval in patients with non-mosaic KS (Okada et al, 2005;Emre Bakircioglu et al, 2006;Ferhi et al, 2009). Therefore, we studied the clinical characteristics of KS patients with and without sperm or germ cells.…”

Section: Discussionmentioning

confidence: 99%

Clinical characteristics of men with non-mosaic Klinefelter syndrome in northeastern China: implications for genetic counseling

Zhang¹,

Ht²,

Hs³

et al. 2015

Genet. Mol. Res.

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ABSTRACT. Klinefelter syndrome (KS) is the most common genetic cause of male infertility. Widespread development in assisted reproductive technology has provided non-mosaic KS patients with the opportunity of having biological children. Testosterone replacement therapy and micro-dissection testicular sperm extraction are effective sperm retrieval techniques for KS patients. Despite the success of sperm retrieval and intracytoplasmic sperm injection (ICSI), some areas of early aggressive hormonal spermatogenesis and appropriate management of KS remain controversial. Androgenotherapy, a common treatment for KS, carries a risk of decreasing focal spermatogenesis by lowering the gonadotropin content. Inadequately treated hypogonadism increases psychosocial morbidity in KS patients. Preventive care must be provided from the time of diagnosis, preferentially through a multidisciplinary approach. This indicates the need for improved genetic counseling of KS patients. The aim of this study was to report the prevalence of non-mosaic KS in a Chinese infertile male population. The rate of early diagnosis was lower in KS patients; most of these were diagnosed after rising concerns of reproductive capacity. The mean age of patients with sperm or germ cells was significantly lower, while the semen volume of these patients was significantly higher. However, the semen volume was negatively correlated with the age and ratio of luteinizing hormone/testosterone content in KS patients. Therefore, genetic counseling of KS patients should focus on early diagnosis and timely treatment, in addition to improving the quality of life of all KS patients. The use of testosterone replacement therapy and/ or micro-dissection testicular sperm extraction should be preferentially considered for fertility preservation.

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“…Early referral of men with KS to a fertility clinic for TESE is proposed, as a younger age (below 32 years) is one of the few established prognostic parameters in predicting successful sperm retrieval (74,75). The need to perform TESE already in adolescence can be questioned, as sperm was found in only one out of five adolescents with KS and in none of the seven adolescents with KS accepting TESE (68,69).…”

Section: Tese Outcomementioning

confidence: 99%

TRANSITION IN ENDOCRINOLOGY: Management of Klinefelter syndrome during transition

Gies

Unuane

Velkeniers

et al. 2014

European Journal of Endocrinology

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Klinefelter syndrome (KS) is the most common sex chromosomal disorder in males. Key findings in older adolescents and young men are small testes with variable hypo-androgenism, but almost universal azoospermia, most frequently in combination with a history of learning difficulties and behavior problems. Males with KS may come to medical attention through different medical presentations, given its association with several congenital malformations, and psychiatric, endocrine, and metabolic disorders. Preventive care is to be provided from diagnosis, preferentially through a multidisciplinary approach, including that from an endocrinologist, clinical psychologist or psychiatrist, neurologist, urologist, geneticist, sexologist, and a fertility team. Accurate information about the condition and assessment of associated medical conditions should be offered at diagnosis and should be followed by psychological counseling. Medical treatment during transition into adulthood is focused on fertility preservation and testosterone replacement therapy in the case of hypo-androgenism, and alleviation of current or future consequences of testicular fibrosis. However, more research is needed to determine the need for pro-active testosterone treatment in adolescence, as well as the conditions for an optimal testosterone replacement and sperm retrieval in adolescents and young men with KS. Furthermore, screening for associated diseases such as metabolic syndrome, autoimmune diseases, thyroid dysfunction, and malignancies is warranted during this period of life. The practical medical management during transition and, more specifically, the role of the endocrinologist are discussed in this article.

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Aging may adversely affect testicular sperm recovery in patients with Klinefelter syndrome

Cited by 77 publications

References 19 publications

Therapy of endocrine disease: Testicular function and fertility in men with Klinefelter syndrome: a review

Therapy of endocrine disease: Testicular function and fertility in men with Klinefelter syndrome: a review

Clinical characteristics of men with non-mosaic Klinefelter syndrome in northeastern China: implications for genetic counseling

TRANSITION IN ENDOCRINOLOGY: Management of Klinefelter syndrome during transition

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