Treatment by testicular sperm extraction and intracytoplasmic sperm injection of 65 azoospermic patients with non‐mosaic Klinefelter syndrome with birth of 17 healthy children
C. Madureira,M. S. Cunha,Mário Sousa,Ana Paula Neto,Manuela Pinho,Paulo Viana,A. Gonçalves,Jorge Sa Silva,J. Teixeira da Silva,C. Oliveira,L. Ferraz,Sofia Dória,Félix Carvalho,Alberto Barros +13 more
TLDR
Clinical and embryological outcomes of 65 azoospermic patients with non‐mosaic Klinefelter syndrome treated by testicular sperm extraction, followed by intracytoplasmic sperm injection, revealed higher fertilization and clinical pregnancy rates with fresh spermatozoa, with no differences regarding implantation or newborn rates.Abstract:
Summary
The aim of this work was to present the clinical and embryological outcomes of 65 azoospermic patients with non-mosaic Klinefelter syndrome (KS), treated by testicular sperm extraction (TESE), followed by intracytoplasmic sperm injection (ICSI), either with fresh or cryopreserved testicular spermatozoa. In total, spermatozoa were recovered in 25/65 (38.5%) of the cases. Of the 48 patients who choose to perform TESE followed by ICSI using fresh testicular spermatozoa (treatment TESE), spermatozoa was recovered in 19 patients (40%), with birth of 12 newborn. Of the 17 patients who choose to perform TESE followed by testicular sperm cryopreservation, spermatozoa were recovered in six patients (35%), with birth of one child. Of the patients who performed treatment TESE, nine went for a new cycle using cryopreserved spermatozoa. Of these, five patients had a previous failed treatment cycle (two patients, three newborn) and four with a previous success went for a new cycle (one patient, one newborn). Overall, the embryological and clinical rates were as follows: 52% of fertilization, 41% of blastocyst, 27% of implantation, 39% of live birth delivery and 47% of newborn. Of the 16 clinical pregnancies, 14 had a successful delivery (12 girls and 5 boys). The 17 newborns had a mean gestation time of 37.2 weeks (35.3% pre-term) and a mean newborn weight of 2781.3 g (37.5% low weight). Comparisons between cycles with fresh and frozen-thaw spermatozoa revealed higher fertilization and clinical pregnancy rates with fresh spermatozoa, with no differences regarding implantation or newborn rates. Of the 17 newborns, no abnormal karyotypes (n = 3) or numerical abnormalities in chromosomes 13, 18, 21, X and Y (n = 14) as evaluated by Multiplex Ligation–dependent Probe Amplification were observed. In conclusion, this study presents further data that reassures that men with KS have no increased risk of transmitting their genetic problem to the offspring.read more
Citations
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Journal ArticleDOI
Sperm recovery and ICSI outcomes in Klinefelter syndrome: a systematic review and meta-analysis
Giovanni Corona,Alessandro Pizzocaro,Fabio Lanfranco,Andrea Garolla,Fiore Pelliccione,Linda Vignozzi,Alberto Ferlin,Carlo Foresta,Emmanuele A. Jannini,Mario Maggi,Andrea Lenzi,Daniela Pasquali,Sandro Francavilla +12 more
TL;DR: The present data suggest that performing TESE/micro-TESE in subjects with KS results in SRRs of close to 50%, and then PRs and LBRs of close-to 50%, with the results being independent of any clinical or biochemical parameters tested.
Journal ArticleDOI
Preliminary Results of a Prospective Study of Testicular Sperm Extraction in Young Versus Adult Patients With Nonmosaic 47,XXY Klinefelter Syndrome
Ingrid Plotton,Sandrine Giscard d’Estaing,Beatrice Cuzin,A. Brosse,Medhi Benchaib,Jacqueline Lornage,René Ecochard,Frédérique Dijoud,Hervé Lejeune +8 more
TL;DR: Performing TESE at a younger age (15-23 y) in patients with azoospermic nonmosaic 47,XXY Klinefelter did not increase SRR relative to adult patients (25-39 y), and previous replacement treatment with moderate doses of T did not seem to be deleterious for the recovery of sperm cells by TESE.
Journal ArticleDOI
Genetics of Male Infertility.
TL;DR: Clinical aspects of male infertility and the role of genetics in elucidating etiologies and the potential of treatments are focused on.
Book ChapterDOI
Prenatal Diagnostic Testing for Genetic Disorders
Kate C. Arnold,Caroline J. Flint +1 more
TL;DR: Antenatal diagnosis of genetic disorders requires the acquisition of fetal or placental tissue andasive procedures are indicated if a fetus is at increased risk for a genetic condition.
Journal ArticleDOI
Testis Development and Fertility Potential in Boys with Klinefelter Syndrome
TL;DR: An overview on what is known of the epidemiology, clinical features, and pathophysiology of KS is provided, followed by a more focused discussion of testicular development and the clinical management of hypogonadism and fertility in boys and men with KS.
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Pregnancies after intracytoplasmic injection of single spermatozoon into an oocyte
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High fertilization and implantation rates after intracytoplasmic sperm injection
Andre Van Steirteghem,Zsolt Nagy,Hubert Joris,Jiaen Liu,Catherine Staessen,Johan Smitz,Arjoko Wisanto,Paul Devroey +7 more
TL;DR: High pregnancy rates were noticed since 67 pregnancies were achieved, of which 53 were clinical, i.e. a total and clinical pregnancy rate of 44.7% and 35.3% per started cycle and 49.6% and 39.2% per embryo transfer.
Journal ArticleDOI
Klinefelter's syndrome
TL;DR: Patients with Klinefelter's syndrome, including the non-mosaic type, need no longer be considered irrevocably infertile, because intracytoplasmic sperm injection offers an opportunity for procreation even when there are no spermatozoa in the ejaculate.