Comparison of Sperm Retrieval and Intracytoplasmic Sperm Injection Outcome in Patients With and Without Klinefelter Syndrome

Sabbaghian, Marjan; Modarresi, Tahereh; Hosseinifar, Hani; Hosseini, Jalil; Farrahi, Faramarz; Dadkhah, Farid; Chehrazi, Mohammad; Khalili, Gholamreza; Gilani, Mohammad Ali Sadighi

doi:10.1016/j.urology.2013.09.021

Cited by 49 publications

(53 citation statements)

References 25 publications

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“…130,131 Several studies have found greater success rates in sperm retrieval for younger men with KS, which conceptually makes sense, given the progressive decline in spermatogonia number described with age in men with KS. 114,132 Therefore, sperm cryopreservation as early as adolescence has been advocated, potentially even in early puberty prior to decline in inhibin B and rise in FSH. 122,133 However, spermatazoa were not found in the ejaculate of 13 adolescent boys with KS, 134 and testicular biopsies in adolescent males have found similar number of spermatogonia to those found in adults with even fewer spermatids.…”

Section: Fertility and Reproductionmentioning

confidence: 99%

Testis Development and Fertility Potential in Boys with Klinefelter Syndrome

Davis

Rogol

Ross

2015

Endocrinology and Metabolism Clinics of North America

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Synopsis Klinefelter syndrome (KS) is the leading genetic cause of primary hypogonadism and infertility in men.1,2 The clinical phenotype has expanded beyond the original description of infertility, small testes and gynecomastia.3 Animal models, epidemiological studies, and clinical research of males with KS throughout the lifespan have allowed us to better characterize the variable phenotype of this condition. This review will provide an overview on what is known of the epidemiology, clinical features, and pathophysiology of KS, followed by a more focused discussion of testicular development and the clinical management of hypogonadism and fertility in men with KS.

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Section: Fertility and Reproductionmentioning

confidence: 99%

Testis Development and Fertility Potential in Boys with Klinefelter Syndrome

Davis

Rogol

Ross

2015

Endocrinology and Metabolism Clinics of North America

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“…22 The sperm retrieval rate in men with Klinefelter syndrome via microdissection TESE has also been reported to be similar or even higher than in those with NOA and normal karyotype. [23][24][25] In our experience, sperms were only found in the two patients with mosaic Klinefelter syndrome but not the one with non-mosaic Klinefelter syndrome. Previous studies showed that sperms are more likely to be retrieved in younger men with Klinefelter syndrome.…”

Section: Discussionmentioning

confidence: 99%

Sperm retrieval rate and pregnancy rate in infertile couples undergoing in-vitro fertilisation and testicular sperm extraction for non-obstructive azoospermia in Hong Kong

Chai

Lee

et al. 2016

Hong Kong Med J

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Objective: There are currently no local data on the sperm retrieval and pregnancy rates in in-vitro fertilisation and testicular sperm extraction cycles, especially with regard to the presence of genetic abnormalities. This study aimed to determine the sperm retrieval and pregnancy rates in infertile couples who underwent in-vitro fertilisation and testicular sperm extraction for non-obstructive azoospermia.Methods: This retrospective case series was conducted at a tertiary assisted reproduction unit in Hong Kong. Men with non-obstructive azoospermia who underwent in-vitro fertilisation and testicular sperm extraction between January 2001 and December 2013 were included. The main outcome measures were sperm retrieval and pregnancy rates.Results: During the study period, 89 men with non-obstructive azoospermia underwent in-vitro fertilisation and testicular sperm extraction. Sperm was successfully retrieved in 40 (44.9%) men. There was no statistically significant difference in the sperm retrieval rate of those with karyotypic abnormalities (2/5, 40.0% vs 28/61, 45.9%; P=1.000) and AZFc microdeletion (3/6, 50.0% vs 28/61, 45.9%; P=1.000) compared with those without. Sperms were successfully retrieved in patients who had mosaic Klinefelter syndrome (2/3, 66.7%) but not in the patient with non-mosaic Klinefelter syndrome. No sperms were found in men with AZFa or AZFb microdeletions. Pregnancy test was positive in 15 (16.9%) patients and the clinical pregnancy rate was 13.5% (12/89) per cycle. The clinical pregnancy rate Sperm retrieval rate and pregnancy rate in infertile couples undergoing in-vitro fertilisation and testicular sperm extraction for nonobstructive azoospermia in Hong KongNew knowledge added by this study • Our study provides important local data for counselling of men with non-obstructive azoospermia. The sperm retrieval rate and clinical pregnancy rate per cycle in men undergoing in-vitro fertilisation and testicular sperm extraction in our unit were 44.9% and 13.5%, respectively.• There was no statistically significant difference in the sperm retrieval and pregnancy rates in those with karyotypic abnormalities and AZFc microdeletion compared with those without. Sperms, however, were not found in men with AZFa or AZFb microdeletions. Implications for clinical practice or policy • Although karyotype abnormalities and AZFc microdeletion did not affect the sperm retrieval and pregnancy rates in couples undergoing in-vitro fertilisation and testicular sperm extraction, karyotype and Y-microdeletion should be checked in men with non-obstructive azoospermia. The risk of vertical transmission of genetic abnormalities should be discussed and couples should be offered appropriate genetic counselling before treatment.

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“…Sperm retrieval rates in microTESE operations range from 22.2% to 79.6% [6,8]. The fact that there are substantial differences between the studies in the literature in terms of sperm retrieval rates by microTESE method and moreover, high sperm retrieval rates even in chromosomal abnormalities such as Klinefelter syndrome in which lower sperm retrieval rates are expected [9], suggested us that there might be important factors that determine success of microTESE.…”

Section: Discussionmentioning

confidence: 99%

“…Direct visualization using surgical microscope in microdissection TESE is of great advantage since larger, more opaque, whitish tubules, presumably containing more intratubular germ cells with active spermatogenesis, can be identified [4].Today, it is known that averagely 50% sperm is retrieved by microTESE surgery [5]. In some studies, however, sperm retrieval rate can be significantly low in microTESE surgeries [6]. Experience of the surgeon in urological surgery depends on many factors.…”

Section: Introductionmentioning

confidence: 99%

Is Learning Curve Short for MicroTESE Operation in Nonobstructive Azoospermic Patients?

Turunç¹,

Kuzgunbay²

2016

Ann Clin Anal Med

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ÖzetAmaç: Nonobstrüktif azospermi hastalarında uygulanan mikrodiseksiyon testiküler sperm ekstraksiyonu (mikroTESE) operasyonunundaki öğrenme eğrisi-ni değerlendirmek. Gereç ve Yöntem: Çalışmaya tek ürolog tarafından mikro-TESE uygulanan 300 nonobstrüktif azospermi (NOA) hastası alındı. Hastalar 3 gruba ayrıldı (ilk 100 hasta, ikinci 100 hasta, üçüncü 100 hasta) ve bu gruplar sperm elde etme oranı (SRR) ile diğer klinik parametreler açısından karşı-laştırıldı. Eğer gruplar arasında SRR açısından fark saptanmazsa ilk 99 hastanın kendi aralarında karşılaştırılması planlandı. Bulgular: Üçyüz hastada toplam SRR %47 idi. Her üç grup arasında SRR açısından anlamlı bir farklılık saptanmadı (sırasıyla %49, %46 ve %46). Bunun üzerine ilk 99 hasta SRR açısın-dan yeniden karşılaştırıldı (ilk 33 hasta, ikinci 33 hasta, üçüncü 33 hasta). Bu gruplar arasında da SRR açısından anlamlı bir farklılık olmadığı görüldü (sı-rasıyla %54.5, %42.4, %51.5). Ayrıca gruplar arasında hastaların yaşları, testis volümleri, serum folikül stimüle edici hormon ve testosteron düzeyleri açı-sından da anlamlı bir farklılık yoktu. Operasyon süresinin ise cerrahi sayısının artması ile birlikte tüm gruplarda anlamlı şekilde azaldığı görüldü. Tartışma:MikroTESE operasyonundaki öğrenme eğrisi, diğer ürolojik cerrahilerdeki öğ-renme eğrilerine göre daha kısadır. Anahtar KelimelerÖğrenme Eğrisi; MikroTESE Operasyonu; Nonobstrüktif Azospermi; Sperm Elde Etme Oranı Abstract Aim: To evaluate learning curve in microdissection testicular sperm extraction (microTESE) surgery performed in non-obstructive azoospermia patients. Material and Method: The study included 300 non-obstructive azoospermic (NOA) patients, who underwent microTESE surgery performed by a single urologist. The patients were divided into three groups (the first 100 patients, the second 100 patients, and the third 100 patients) and these groups were compared in terms of sperm retrieval rate (SRR) and other clinical parameters. It was planned to compare the patients in first 99 patients between themselves in case there is no difference between the groups in terms of SRR. Results: The overall SRR was 47% in 300 NOA patients. No significant difference was determined between the three groups in terms of SRR (49%, 46%, and 46%, respectively). Accordingly, the first 99 patients were re-compared in terms of SRR (the first 33 patients, the second 33 patients, and the third 33 patients). It was observed that there is also no significant difference between these groups in terms of SRR (54.5%, 42.4%, and 51.5%, respectively). Moreover, no significant difference was determined between all of the groups in terms of patient age, testis volume, and serum folliclestimulating hormone and testosterone levels. It was observed that duration of surgery has been significantly shortened in all groups as the number of surgical procedures increased. Discussion: Learning curve in microTESE surgery is shorter according to learning curves in other urological surgeries.

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Comparison of Sperm Retrieval and Intracytoplasmic Sperm Injection Outcome in Patients With and Without Klinefelter Syndrome

Cited by 49 publications

References 25 publications

Testis Development and Fertility Potential in Boys with Klinefelter Syndrome

Testis Development and Fertility Potential in Boys with Klinefelter Syndrome

Sperm retrieval rate and pregnancy rate in infertile couples undergoing in-vitro fertilisation and testicular sperm extraction for non-obstructive azoospermia in Hong Kong

Is Learning Curve Short for MicroTESE Operation in Nonobstructive Azoospermic Patients?

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