Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2021 Feb 18:3:636629.
doi: 10.3389/frph.2021.636629. eCollection 2021.

How Successful Is Surgical Sperm Retrieval in Klinefelter Syndrome?

Yamini Kailash  1 , Amr Abdel Raheem  2   3 , Sheryl T Homa  4   5
Affiliations
Review

How Successful Is Surgical Sperm Retrieval in Klinefelter Syndrome?

Yamini Kailash et al. Front Reprod Health. .

Abstract

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.

Keywords: Klinefelter syndrome; MicroTESE; TESE; hormone stimulation; surgical sperm retrieval; testicular sperm extraction.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flow chart of the management of azoospermic KS patients.
See this image and copyright information in PMC

References

    1. Klinefelter H, Reifenstein E, Albright F. Syndrome characterized by gynecomastia, aspermatogenesis without A-leydigism, and increased excretion of follicle-stimulating hormone. J Clin Endocrinol Metab. (1942) 2:615–27. 10.1210/jcem-2-11-615 - DOI
    1. Jacobs PA, Strong JA. A case of human intersexuality having a possible XXY sex-determining mechanism. Nature. (1959) 183:302–3. 10.1038/183302a0 - DOI - PubMed
    1. Lanfranco F, Kamischke A, Zitzmann M, Nieschlag E. Klinefelter's syndrome. Lancet. (2004) 364:273–83. 10.1016/S0140-6736(04)16678-6 - DOI - PubMed
    1. Bonomi M, Rochira V, Pasquali D, Balercia G, Jannini EA, Ferlin A, et al. Klinefelter syndrome (KS): genetics, clinical phenotype and hypogonadism. J Endocrinol Invest. (2017) 40:123–34. 10.1007/s40618-016-0541-6 - DOI - PMC - PubMed
    1. Völkl TM, Langer T, Aigner T, Greess H, Beck JD, Rauch AM, et al. Klinefelter syndrome and mediastinal germ cell tumors. Am J Med Genet Part A. (2006) 140:471–81. 10.1002/ajmg.a.31103 - DOI - PubMed

LinkOut - more resources