Sperm retrieval by microdissection testicular sperm extraction and intracytoplasmic sperm injection outcomes in nonobstructive azoospermic patients with Klinefelter syndrome

Özer, Cevahir; Aytaç, Pınar Çağlar; Gören, Mehmet Reşit; Toksöz, Serdar; Gül, Ümit; Turunç, Tahsin

doi:10.1111/and.12983

Cited by 23 publications

(29 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Madgar et al, 36 for example, showed that testicular volume was significantly higher in men with positive SRR. However, there are several studies reporting that testicular atrophy does not affect the success of SR. 9,[27][28][29]32,37 Garolla et al, 28 indeed, observed a 23% SRR even in KS patients with testicles < 1 mL. Our results support these findings as we failed to find any relationship between testicular volume and SRR in NOA patients with KS.…”

Section: Discussionsupporting

confidence: 86%

“…30,31 Ozer at al. 32 34 We also confirm that SRR was not influenced by patient's age in a real-life study with a large cohort of Klinefelter men. According to this view, it has been postulated that the progressive hyalinization and fibrosis of seminiferous tubules that is accelerated with the onset of puberty in KS are not ubiquitous and it is possible to observe tubules with normal residual activity.…”

Section: Discussionsupporting

confidence: 80%

“…Higher serum testosterone levels were found in Klinefelter men with positive SR as compared to those with negative SR. 31,32 Similarly, the combination of high testosterone levels and low levels of LH was considered as positive predictive marker for SR in both adolescents and adults with KS. 38,39 Conversely, recent meta-analytic data showed that serum hormones levels did not influence SRR in Klinefelter patients.…”

Section: Discussionmentioning

confidence: 99%

“…Figure 1shows the distribution of patients among the five centers. Median (IQR) patient's age was 32(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37) years. Baseline serum FSH and total testosterone levels were 29.5 (19.9-40.9) mUI/mLand 3.8 (2.5-11.0) ng/mL, respectively.…”

mentioning

confidence: 99%

See 3 more Smart Citations

Sperm retrieval rates in non‐mosaic Klinefelter patients undergoing testicular sperm extraction: What expectations do we have in the real‐life setting?

et al. 2020

View full text Add to dashboard Cite

Background: A recent meta-analysis (Human Reproduction Update 23, 2017 and 265) reported positive sperm retrieval rates (SRR) in 50% of patients with Klinefelter syndrome (KS) undergoing testicular sperm extraction (TESE). However, these results do not reflect the rates of SR that we observe in clinical practice. We assessed the rate and potential predictors of SR in Klinefelter patients in the real-life setting. Materials and Methods:We reviewed clinical data of 103 KS men who underwent TESE between 08/2008 and 03/2019 at five tertiary referral Andrology centers. Patients underwent testis ultrasound, hormonal evaluation, and genetic testing. All patients were azoospermic based on the 2010 WHO reference criteria. Conventional TESE (cTESE) or microsurgical TESE (mTESE) was performed based on the surgeon's preference. We used descriptive statistics and logistic regression models to describe the whole cohort.Results: Median (IQR) patient's age was 32 (24-37) years. Baseline serum FSH and total testosterone levels were 29.5 (19.9-40.9) mUI/mL and 3.8 (2.5-11.0) ng/mL, respectively. Conventional TESE and mTESE were performed in 38 (36.5%) and 65 (63.5%) men, respectively. The sperm retrieval rate was 21.4% (22/103 men). Fifteen patients used spermatozoa for ICSI and five ended in live birth children. Patients with positive SR were similar to those with a negative TESE in terms of clinical, hormonal, and procedural parameters (all P > .05). Logistic regression analyses confirmed the lack of association between clinical, hormonal, and procedural parameters with SR outcome. Discussion: Given the conflicting results in the literature regarding SRR in KS, patients should be carefully counseled regarding TESE outcomes based on data from published literature and local results.

show abstract

Section: Discussionsupporting

confidence: 86%

Section: Discussionsupporting

confidence: 80%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

Sperm retrieval rates in non‐mosaic Klinefelter patients undergoing testicular sperm extraction: What expectations do we have in the real‐life setting?

et al. 2020

View full text Add to dashboard Cite

show abstract

“…Ozer et al 37 analyzed data from 110 KS men submitted to mTESE and found that lower FSH and higher tT values were predictors for positive SR. In particular, they showed that men with tT values ≥ 2.95 ng/ml had a 4‐time higher change of positive SR compared to those with tT levels below the threshold 37 . The combination of higher tT and lower LH values was also found to be associated with positive SR in adolescent and adult KS 12,38,39 .…”

Section: Discussionmentioning

confidence: 99%

Rates of hypogonadism forms in Klinefelter patients undergoing testicular sperm extraction: A multicenter cross‐sectional study

et al. 2020

View full text Add to dashboard Cite

Introduction and objectives Adult patients with Klinefelter syndrome (KS) may present with testicular volume loss and a decrease in circulating testosterone (T) levels. However, the actual rate of hypogonadism in adult KS men is unknown. We aimed to (a) assess the prevalence of different forms of hypogonadism in a cohort of KS patients with non‐obstructive azoospermia (NOA); and (b) investigate potential preoperative predictor of positive sperm retrieval (SR) at surgery in the same cohort of men. Methods Complete data from 103 KS men with NOA who underwent testicular sperm extraction (TESE) between 2008 and 2019 at five centers were analyzed. Comorbidities were scored with the Charlson Comorbidity Index (CCI). Patients were categorized into four groups of hypogonadism as follows: eugonadism [normal total T (tT) (≥3.03 ng/mL) and normal luteinizing hormone (LH) (≤9.4 mUI/mL)], secondary hypogonadism [low tT (≤3.03 ng/mL) and low/normal LH (≤9.4 mUI/mL)], primary hypogonadism [low tT (≤3.03 ng/mL) and elevated LH (≥9.4 mUI/mL)], and compensated hypogonadism [normal tT (≥3.03 ng/mL) and elevated LH (≥9.4 mUI/mL)]. Descriptive statistics tested the association between clinical characteristics and laboratory values among the four groups. Results Median (IQR) patients age was 32 (24, 37) years. Baseline follicle‐stimulating hormone and tT levels were 29.5 (19.9, 40.9) mUI/mL and 3.8 (2.5, 11.0) ng/mL, respectively. Eugonadism, primary hypogonadism, and compensated hypogonadism were found in 16 (15.6%), 34 (33.0%), and 53 (51.4%) men, respectively. No patients had secondary hypogonadism. Positive SR rate at TESE was 21.4% (22 patients); of 22, 15 (68.2%) patients underwent assisted reproductive technology and five (22.7%) ended in live birth children. Patients’ age, BMI, CCI, FSH levels, and positive SR rates were comparable among hypogonadism groups. No preoperative parameters were associated with positive SR at logistic regressions analysis. Conclusions Findings from this cross‐sectional study showed that 15.6% of adult KS men have normal tT values at presentation in the real‐life setting. Most KS patients presented with either compensated or primary hypogonadism. Sperm retrieval rates were not associated with different forms of hypogonadism.

show abstract

Differences in clinical outcomes between men with mosaic Klinefelter syndrome and those with non‐mosaic Klinefelter syndrome

Tsukamoto,

Enatsu,

Nakahara

et al. 2024

Reprod Medicine & Biology

View full text Add to dashboard Cite

PurposeThis study compared the clinical outcomes of men with Klinfelter syndrome based on karyotype.MethodsThe authors analyzed the outcomes of microdissection testicular sperm extraction (micro‐TESE) performed on 57 patients with Klinfelter syndrome (KS) at our clinic.ResultsThe average ages of the non‐mosaic and mosaic KS groups were 32.2 ± 4.8 and 45.9 ± 13.1 years, respectively. The sperm retrieval rates of the non‐mosaic and mosaic KS groups were 46.5% (20/43) and 50.0% (7/14), respectively. The fertilization rates after intracytoplasmic sperm injection did not significantly differ between the non‐mosaic and mosaic KS groups. The mosaic KS group had higher cleavage and blastocyst development rates than the non‐mosaic KS group (72.2% vs. 96.2% and 30.5% vs. 44.7%, respectively). The group using motile sperm had better outcomes than the group using immotile sperm. The embryo transfer outcomes of the non‐mosaic and mosaic KS groups did not significantly differ (clinical pregnancy rate: 28.0% vs. 20.7%, miscarriage rate: 14.3% vs. 33.3%, production rate per transfer: 22.0% vs. 13.8%, and production rate per case: 58.8% vs. 57.1%).ConclusionsCompared with the non‐mosaic KS group, the mosaic KS group had significantly better intracytoplasmic sperm injection outcomes because of the higher utilization rate of motile sperm.

show abstract

Sperm retrieval by microdissection testicular sperm extraction and intracytoplasmic sperm injection outcomes in nonobstructive azoospermic patients with Klinefelter syndrome

Cited by 23 publications

References 32 publications

Sperm retrieval rates in non‐mosaic Klinefelter patients undergoing testicular sperm extraction: What expectations do we have in the real‐life setting?

Sperm retrieval rates in non‐mosaic Klinefelter patients undergoing testicular sperm extraction: What expectations do we have in the real‐life setting?

Rates of hypogonadism forms in Klinefelter patients undergoing testicular sperm extraction: A multicenter cross‐sectional study

Differences in clinical outcomes between men with mosaic Klinefelter syndrome and those with non‐mosaic Klinefelter syndrome

Contact Info

Product

Resources

About