Klinefelter syndrome: does it confer a bad prognosis in treatment of nonobstructive azoospermia?

Bakırcıoğlu, Emre; Uluğ, Ulun; Erden, Halit Firat; Tosun, Süleyman; Bayram, A; Ciray, H. Nadir; Bahçeci, Mustafa

doi:10.1016/j.fertnstert.2011.01.005

Cited by 53 publications

(46 citation statements)

References 24 publications

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“…67 Lastly, in adult azoospermic 47,XXY Klinefelter patients, spermatozoa can be recovered for ICSI. 68,69 Apart from a multiple biopsy approach, the most important factor to improve sperm recovery from testicular specimens is the microscopic assessment of the wet preparation and the concomitant application of erythrocyte-lysing buffer and/or enzymatic digestion. 70,71 In men with NOA, including 47,XXY males, there is controversy on the timing of TESE relative to the cycle of ICSI.…”

Section: Azoospermia and Icsimentioning

confidence: 99%

Male factor infertility and ART

Tournaye¹

2011

Asian J Androl

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Section: Azoospermia and Icsimentioning

confidence: 99%

Male factor infertility and ART

Tournaye¹

2011

Asian J Androl

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“…Literatürde KS hastalarında TESE ile sperm eldesi %50 olarak raporlanmıştır ve normal karyotipli non-obstrüktif azospermili hastalarla benzer bulunmuştur (8,9). KS tanılı hastalarda TESE ile sperm bulma başarısının belirteçleri üzerinde literatürde çalışmalar mevcuttur.…”

Section: Introductionunclassified

“…KS tanılı hastalarda TESE ile sperm bulma başarısının belirteçleri üzerinde literatürde çalışmalar mevcuttur. Bu çalışmalarda hastaların yaşı tek önemli prognostik faktör olarak saptanmıştır (9)(10)(11)(12)(13)(14). Biz de bu çalışmamızda KS olgularında TESE öncesi sperm bulma başarısını etkileyebilecek prediktif faktörlerin belirlenmesini amaçladık.…”

Section: Introductionunclassified

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Klinefelter sendromlu azospermik olgularda testiküler sperm ekstraksiyonu (TESE) başarısı için prediktif faktörler

Keskın¹,

Budak²,

Köse³

et al. 2016

Ege Tıp Dergisi

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Amaç: Klinefelter sendromu (KS) olgularında testiküler sperm ekstraksiyonu (TESE) başarısı için prediktif parametrelerin değerlendirilmesi amaçlandı. Gereç ve Yöntem:Çalışmamızda hastanemizde 2009-2014 yıllarında non-obstrüktif azospermi (NOA) nedeniyle TESE yapılmış 322 hastanın verileri retrospektif olarak incelendi. Bu hastalardan genetik analizi 47XXY -KS olarak saptanan 29 hasta çalışmaya alınarak yaş, FSH, LH, FSH/LH oranı, prolaktin, T ve E2 değerleri retrospektif olarak incelendi. Parametrelerin istatistiksel analizinde, p<0.05 değeri anlamlı kabul edildi. Bulgular:Hastaların ortalama yaş, FSH, LH, FSH/LH oranı, Prolaktin, T ve E2 değerleri sırasıyla 32 yıl, 38.4 mIU/mL, 18.84 mIU/mL, 2.04, 11 ng/mL, 216.74 ng/dL ve 24.37 pg/mL olarak saptandı. TESE başarımız % 37.9 idi. TESE başarısını belirlemede etkili tek parametre yaş faktörüydü (p=0.007). FSH, LH, FSH/LH oranı, prolaktin, T ve E2 parametrelerinin bağımsız örneklem t test değerleri sırasıyla p=0.185, p=0.510, p=0.119, p=0.545, p=0.841, p=0.139 olarak bulundu ve non-prediktif oldukları görüldü.Sonuç: KS olgularında TESE başarısı için biyopsi dışında tek prediktif parametre yaştır. Otuz iki yaş ve altında TESE başarısı anlamlı derecede yüksektir.Anahtar Sözcükler: İnfertilite, Klinefelter sendromu, TESE başarısı, prediktivite. Abstract Aim: It is aimed to identify the predictive factors for testicular sperm extraction (TESE) success in cases with Klinefelter syndrome (KS). Materials and Methods: We retrospectively analyzed 322 patients that underwent TESE operation because of nonobstructive azoospermia (NOA) in our hospital between 2009 and 2014. Twenty-nine patients whose genetic analysis reported 47XXY -KS were included in our study. Age, FSH, LH, FSH/LH ratio, prolactin, T and E2 values of these 29patients were analysed retrospectively. In statistical analysis of these parameters, p value <0.05 was accepted as significant. Results:The mean age, FSH, LH, FSH/LH ratio, prolactin, T and E2 value of the patients were; 32 years, 38.4 mIU/mL, 18.84 mIU/mL, 2.04, 11 ng/mL, 216.74 ng/dL and 24.37 pg/mL, respectively FSH, LH, FSH/LH ratio, prolactin, T and E2 were p=0.185; p=0.510; p=0.119; p=0.545; p=0.841; p=0.139 respectively and were non-predictive. Conclusion:In KS cases, the only predictive parameter for TESE success is age, except biopsy. TESE success was found significantly higher at 32 years of age and under.

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“…In such cases, the semen samples or testicular tissue samples (obtained by microsurgical testis sperm extraction) of boys with KS could be frozen at the onset of puberty (Gies et al, 2012). Bakircioglu et al (2011) reported similar sperm recovery rates in men with KS and those with NOA and normal karyotypes. The fertilization rate was (statistically) significantly lower in men with KS than in men with non-obstructive azoospermia; however, the pregnancy and abortion rates were found to be similar.…”

Section: Introductionmentioning

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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Klinefelter syndrome: does it confer a bad prognosis in treatment of nonobstructive azoospermia?

Cited by 53 publications

References 24 publications

Male factor infertility and ART

Male factor infertility and ART

Klinefelter sendromlu azospermik olgularda testiküler sperm ekstraksiyonu (TESE) başarısı için prediktif faktörler

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

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