Sperm retrieval from patients with nonmosaic Klinefelter’s syndrome by semen cytology examination

Jiang, Yuting; Dong, Yaping; Yu, Xiaowei; Rong-bin, DU; Li, L.-L.; Zhang, H.-G.; Liu, R.-Z.

doi:10.4238/2014.march.17.12

Cited by 4 publications

(4 citation statements)

References 24 publications

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“…While most studies fail to show an association between testosterone, LH, FSH, inhibin B, AMH and estradiol levels on SSR rates in KS patients ( 22 , 29 , 43 , 44 ), the role of testosterone, FSH and LH is not clearly defined. Some argue that higher testosterone and lower LH levels are predictive of successful spermatozoa retrieval ( 44 , 51 ) while lower testosterone levels are associated with worse SSR outcomes ( 52 , 53 ). The role of FSH levels as a predictor for successful SSR was found to be variable according to some studies ( 42 , 54 ).…”

Section: Physical Characteristics and Comorbiditiesmentioning

confidence: 99%

How Successful Is Surgical Sperm Retrieval in Klinefelter Syndrome?

Kailash

Raheem

Homa

2021

Front. Reprod. Health

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Klinefelter Syndrome (KS) is characterized by the presence of an extra X chromosome. It was first diagnosed in 1942 in a group of azoospermic men. KS is the most common chromosomal abnormality encountered in infertile men and accounts for more than 10% of the causes of azoospermia. Men who are azoospermic may still father children via testicular sperm extraction followed by intracytoplasmic sperm injection (ICSI). This review article summarizes the success rates of the available techniques for surgical sperm retrieval (SSR) in KS including conventional testicular sperm extraction (cTESE) and micro testicular sperm extraction (mTESE), as well as the risks of these procedures for future fertility. The evidence indicates that the SSR rate is as successful in non-mosaic men with KS as those with normal karyotypes, with retrieval rates of up to 55% reported. The influence of different factors that affect the chances of a successful outcome are discussed. In particular, the impact of aneuploidy rate, physical characteristics, co-morbidities, reproductive endocrine balance and the use of different hormone management therapies are highlighted. Evidence is presented to suggest that the single most significant determinant for successful SSR is the age of the patient. The success of SSR is also influenced by surgical technique and operative time, as well as the skills of the surgeon and embryology team. Rescue mTESE may be used successfully following failed TESE in KS patients in combination with hormone stimulation.

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Section: Physical Characteristics and Comorbiditiesmentioning

confidence: 99%

How Successful Is Surgical Sperm Retrieval in Klinefelter Syndrome?

Kailash

Raheem

Homa

2021

Front. Reprod. Health

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“…В подавляющем большинстве случаев у мужчин с немозаичной формой СК определяются малое количество эякулята и азооспермия [4]. По данным исследований, при использовании стандартной процедуры анализа эякулята, рекомендуемой ВОЗ, возможность обнаружения живых сперматозоидов у пациентов с СК составляет около 6-8% [19,20]. В то же время Jiang и соавт.…”

Section: исследование эякулятаunclassified

“…Других предикторов (возраст, уровень тестостерона), способных прогнозировать вероятность положительного исхода исследования эякулята, найдено не было [25]. В противоположность этому, Jiang et al выявили наличие корреляционной связи между вероятностью получения сперматозоидов в эякуляте и такими факторами, как возраст пациента (чем моложе пациент, тем более высока вероятность обнаружения живых сперматозоидов), уровень Т крови (высокий уровень как положительный фактор) и значение соотношения Т/ЛГ (более высокое значение как положительный фактор) [20]. Важно учитывать, что в связи с физиологическими и психологическими особенностями далеко не все пациенты подросткового возраста готовы обсуждать и планировать вопросы фертильности и будущего потомства, что подтверждают исследования Nahata et al и Rohayem et al, где около 50% опрошенных в возрасте от 12 до 25 лет отказались участвовать в исследовании [24,26].…”

Section: исследование эякулятаunclassified

Klinefelter syndrome: literature review on using modern methods of assisted reproductive technologies

Воронцова

Kalinchenko

2020

Probl Endokrinol (Mosk)

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The article reviews scientific papers devoted to the problem of reproductive health in men with Klinefelter syndrome (KS). Pathogenesis from a very early age (in utero), the possibility of ensuring biological paternity upon reaching sexual maturity and the risk of chromosomal abnormalities in offspring are discussed. Despite the fact that KS is one of the most common causes of male infertility associated with chromosomal abnormalities, due to the variability of clinical manifestations the proportion of patients identified before puberty did not exceed 10% before the widespread introduction of non-invasive prenatal testing. According to the research results presented in the article, the reproductive potential of males with KS is often already reduced in early childhood. These circumstances should be considered when choosing further patient management tactics.There are few reports on the onset of spontaneous pregnancy in the case of KS, so ensuring biological paternity in this group of patients is often possible only using surgical methods of sperm extraction and assisted reproductive technologies. This article discusses methods like testicular sperm extraction (TESE) and microdissection testicular sperm extraction (mTESE) in terms of their effectiveness and safety for the patient, and the factors influencing the outcome of the operation. The optimal period of these manipulations seems to be the patient’s age from 18 to 30 years, although the feasibility of adolescent boys undergoing the aforementioned procedures is highly controversial.The research papers presented in the article suggest that the risk of transmitting chromosomal abnormalities to offspring is rather low, which does not exclude the need for medical and genetic counseling to explain all possible risks to the patient. Preimplantation or intrauterine diagnostics are also deemed necessary.

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“…If no sperm was found, semen cytology examination was conducted by sedimentation of semen samples through centrifugation, washing thrice with phosphatebuffered saline (pH 7.2), spreading the washed semen on glass slides, and allowing the spread semen to air-dry. Hema toxylin-eosin staining was performed on the specimen after fixing with 95% alcohol (Jiang et al, 2014). The cells were examined under high magnification using a 40X light microscope.…”

Section: Semen Analysis and Semen Cytology Examinationmentioning

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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Sperm retrieval from patients with nonmosaic Klinefelter’s syndrome by semen cytology examination

Cited by 4 publications

References 24 publications

How Successful Is Surgical Sperm Retrieval in Klinefelter Syndrome?

How Successful Is Surgical Sperm Retrieval in Klinefelter Syndrome?

Klinefelter syndrome: literature review on using modern methods of assisted reproductive technologies

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

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