The Klinefelter Syndrome and Testicular Sperm Retrieval Outcomes

被引:14
|
作者
Sa, Rosalia [1 ,2 ,3 ,4 ]
Ferraz, Luis [5 ]
Barros, Alberto [6 ,7 ,8 ]
Sousa, Mario [1 ,2 ,3 ]
机构
[1] Univ Porto, ICBAS Sch Med & Biomed Sci, Dept Microscopy, Lab Cell Biol, Rua Jorge Viterbo Ferreira 228, P-4050313 Porto, Portugal
[2] UMIB Unit Multidisciplinary Res Biomed, P-4050313 Porto, Portugal
[3] ITR Lab Integrat & Translat Res Populat Hlth, Rua Taipas 135, P-4050600 Porto, Portugal
[4] Univ Porto, Fac Med, Alameda Prof Hernani Monteiro, P-4200319 Porto, Portugal
[5] Ctr Hosp Vila Nova De Gaia Espinho, Hosp Eduardo Santos Silva, Dept Urol, Rua Conceicao Fernandes, P-4434502 Vila Nova De Gaia, Portugal
[6] Univ Porto, Fac Med, Dept Genet, Alameda Prof Hernani Monteiro, P-4200319 Porto, Portugal
[7] Ctr Reprod Genet A Barros, Av Bessa 240, 1 Dto Frente, P-4100012 Porto, Portugal
[8] Univ Porto, Inst Hlth Res & Innovat IPATIMUP i3S, Rua Alfredo Allen 208, P-4200135 Porto, Portugal
关键词
Klinefelter syndrome; epidemiology; etiology; genetic causes; metabolic syndrome; testis; spermatogenesis; testicular sperm retrieval; predictive factors; newborn; ANTI-MULLERIAN HORMONE; IN-SITU HYBRIDIZATION; SERUM FSH-LEVELS; INTRACYTOPLASMIC INJECTION; 47; XXY KLINEFELTER; SEX-CHROMOSOMES; EJACULATED SPERMATOZOA; METABOLIC SYNDROME; X-CHROMOSOME; GERM-CELLS;
D O I
10.3390/genes14030647
中图分类号
Q3 [遗传学];
学科分类号
071007 ; 090102 ;
摘要
Klinefelter syndrome (KS), caused by the presence of an extra X chromosome, is the most prevalent chromosomal sexual anomaly, with an estimated incidence of 1:500/1000 per male live birth (karyotype 47,XXY). High stature, tiny testicles, small penis, gynecomastia, feminine body proportions and hair, visceral obesity, and testicular failure are all symptoms of KS. Endocrine (osteoporosis, obesity, diabetes), musculoskeletal, cardiovascular, autoimmune disorders, cancer, neurocognitive disabilities, and infertility are also outcomes of KS. Causal theories are discussed in addition to hormonal characteristics and testicular histology. The retrieval of spermatozoa from the testicles for subsequent use in assisted reproduction treatments is discussed in the final sections. Despite testicular atrophy, reproductive treatments allow excellent results, with rates of 40-60% of spermatozoa recovery, 60% of clinical pregnancy, and 50% of newborns. This is followed by a review on the predictive factors for successful sperm retrieval. The risks of passing on the genetic defect to children are also discussed. Although the risk is low (0.63%) when compared to the general population (0.5-1%), patients should be informed about embryo selection through pre-implantation genetic testing (avoids clinical termination of pregnancy). Finally, readers are directed to a number of reviews where they can enhance their understanding of comprehensive diagnosis, clinical care, and fertility preservation.
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页数:26
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