Sperm retrieval rates in non-mosaic Klinefelter patients undergoing testicular sperm extraction: What expectations do we have in the real-life setting?

被引：25

作者：

Boeri, Luca ^{[1
,2
]}

Palmisano, Franco ^{[1
]}

Preto, Mirko ^{[3
]}

Sibona, Mattia ^{[3
]}

Capogrosso, Paolo ^{[2
]}

Franceschelli, Alessandro ^{[4
]}

Ruiz-Castane, Eduard ^{[5
]}

Sarquella-Geli, Joaquim ^{[5
]}

Bassas-Arnau, Lluis ^{[5
]}

Scroppo, Fabrizio Ildefonso ^{[6
]}

Sacca, Antonino ^{[7
]}

Gentile, Giorgio ^{[4
]}

Falcone, Marco ^{[3
]}

Timpano, Massimiliano ^{[3
]}

Ceruti, Carlo ^{[3
]}

Gadda, Franco ^{[1
]}

Trost, Landon ^{[8
]}

Colombo, Fulvio ^{[4
]}

Rolle, Luigi ^{[3
]}

Gontero, Paolo ^{[3
]}

Montorsi, Francesco ^{[2
]}

Sanchez-Curbelo, Josvany ^{[5
]}

Salonia, Andrea ^{[2
]}

Montanari, Emanuele ^{[1
]}

机构：

[1] Univ Milan, Fdn IRCCS Ca Granda Osped Maggiore Policlin, Dept Urol, Via Commenda 15, I-20122 Milan, Italy

[2] IRCCS Osped San Raffaele, URI, Div Expt Oncol, Unit Urol, Milan, Italy

[3] AOU Citta Salute & Sci Torino Presidio Molinette, Div Urol, Turin, Italy

[4] Univ Hosp S Orsola, Androl Unit, Bologna, Italy

[5] Univ Autonoma Barcelona, Dept Androl, Fundacio Puigvert, Barcelona, Spain

[6] Osped Circolo & Fdn Macchi, Dept Urol & Androl, Varese, Italy

[7] AO Papa Giovanni XXIII, Dept Urol, Bergamo, Italy

[8] Mayo Clin, Dept Urol, Rochester, MN USA

来源：

ANDROLOGY | 2020年 / 8卷 / 03期

关键词：

male infertility; Klinefelter syndrome; sperm retrieval; azoospermia; predictors; NONOBSTRUCTIVE AZOOSPERMIA; ICSI OUTCOMES; MEN; FERTILITY; SPERMATOZOA; INJECTION; RECOVERY; PRESERVATION; STRATEGY; SUCCESS;

D O I：

10.1111/andr.12767

中图分类号：

R69 [泌尿科学（泌尿生殖系疾病）];

学科分类号：

摘要：

Background A recent meta-analysis (Human Reproduction Update 23, 2017 and 265) reported positive sperm retrieval rates (SRR) in 50% of patients with Klinefelter syndrome (KS) undergoing testicular sperm extraction (TESE). However, these results do not reflect the rates of SR that we observe in clinical practice. We assessed the rate and potential predictors of SR in Klinefelter patients in the real-life setting. Materials and Methods We reviewed clinical data of 103 KS men who underwent TESE between 08/2008 and 03/2019 at five tertiary referral Andrology centers. Patients underwent testis ultrasound, hormonal evaluation, and genetic testing. All patients were azoospermic based on the 2010 WHO reference criteria. Conventional TESE (cTESE) or microsurgical TESE (mTESE) was performed based on the surgeon's preference. We used descriptive statistics and logistic regression models to describe the whole cohort. Results Median (IQR) patient's age was 32 (24-37) years. Baseline serum FSH and total testosterone levels were 29.5 (19.9-40.9) mUI/mL and 3.8 (2.5-11.0) ng/mL, respectively. Conventional TESE and mTESE were performed in 38 (36.5%) and 65 (63.5%) men, respectively. The sperm retrieval rate was 21.4% (22/103 men). Fifteen patients used spermatozoa for ICSI and five ended in live birth children. Patients with positive SR were similar to those with a negative TESE in terms of clinical, hormonal, and procedural parameters (all P > .05). Logistic regression analyses confirmed the lack of association between clinical, hormonal, and procedural parameters with SR outcome. Discussion Given the conflicting results in the literature regarding SRR in KS, patients should be carefully counseled regarding TESE outcomes based on data from published literature and local results. Conclusions In the real-life setting, we observed a lower SRR (21.4%) than that reported in meta-analyses in our cohort of KS patients. No associations between clinical, hormonal, and procedural variables with TESE success were found.

引用

页码：680 / 687

页数：8

共 44 条

[1] Testicular function and fertility in men with Klinefelter syndrome: a review [J].