Seven pregnancies and deliveries from non-mosaic Klinefelter syndrome patients using fresh and frozen testicular sperm

Abstract

Purpose: The aim of this study was to investigate the feasibility of using frozen-thawed testicular sperm as well as the timing of testicular sperm extraction (TESE) in patients with non-mosaic Klinefelter syndrome.Methods: Intracytoplasmic sperm injection (ICSI) was performed in six of 17 (35%) patients whose sperm was recovered by TESE. Multiple biopsies of both testes were performed on the day of oocyte retrieval in all but one of the six patients.Results: Seven pregnancies and deliveries were achieved in five couples, and one couple was unsuccessful. Five pregnancies were achieved using fresh motile sperm, and two were achieved using frozen-thawed sperm. Sperm cryopreservation was not possible in one of the five couples because of the small number of recovered sperm, and possible in four other couples for subsequent ICSI. One woman whose husband had TESE performed prior to ovarian stimulation did not become pregnant. This may be due to the attainment Conclusion: The outcome of ICSI using fresh or frozenthawed testicular sperm in patients with non-mosaic Klinefelter syndrome was identical; however, TESE should be performed on the day of oocyte retrieval until such time as a procedure with a higher sperm yield from TESE is available. Moreover, an improved recovery procedure after cryopreservation-thawing of a single spermatozoon must be developed.

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

“…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).…”

“…However, in two recent studies of nonmosaic KS patients all meiotic spermatocytes were normally euploid and thus able to mature into haploid spermatozoa (25,103). Thus, at least 149 healthy live born babies without anomalies were conceived after TESE/ICSI from couples, including a 47,XXY father, have been reported worldwide (13,48,52,56,58,59,60,61,63,64,65,67,68,69,70,72,74,75,100,104,105,106,107,108).…”

Fresh motile testicular sperm retrieved from nonobstructive azoospermic patients has the same potential to achieve fertilization and pregnancy via ICSI as sperm retrieved from obstructive azoospermic patients

“…We previously reported the pregnancies and deliveries from nonmosaic Klinefelter syndrome patients using fresh and frozen testicular sperm (10). In that report, frozen-thawed testicular sperm also was found to result in pregnancy; however, the outcome with fresh testicular sperm was better.…”

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

“…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.…”