Comparison of ICSI outcomes between nonobstructive azoospermic males with normal karyotype and klinefelter's syndrome

Abstract

OBJECTIVE: Klinefelter's syndrome affects approximately 10% of men with nonobstructive azoospermia (NOA). Recent years, using advance sperm recovery techniques increased success rate of sperm recovery from severely impaired testis. In this study, we compared testicular sperm extraction (TESE) and ICSI outcomes between chromosomally normal men with NOA and men with KS.DESIGN: A retrospective study.MATERIALS AND METHODS: Three hundred and seventy nine NOA men with normal karyotype and 106 men who were diagnosed nonmosaic KS were included in this study. All patients underwent microdissection TESE (micro TESE) operation and fresh sperm were used for ICSI. Sperm retrieval rates, ICSI results including fertilization, clinical pregnancy and abortion rates were compared between two groups. The cycles in which age of women older than 38 years and number of oocytes less than 4 were excluded to avoid the affect of female factor.Tabled 1ICSI outcomes of patients with NOA and KSNOA (%)KS (%)pFertilization64,856,8〈0,001Pregnancy55530,81Abortion1211,50,95 Open table in a new tab The pregnancies were resulted 28 live births in KS group and 1 pregnancy is still on going. Twenty of the children tested for karyotype analysis and found normal karyotype.CONCLUSIONS: Micro TESE is a successful technique for sperm recovery in KS patients and age of the patient has an affect on sperm recovery. Although fertilizing ability of sperm in ICSI was significantly lower of in men with KS, pregnancy and abortion rates did not show any difference than NOA group. The infertility treatment of KS patients with micro TESE and ICSI is comparable as the treatment of NOA patients with normal karyotpe. OBJECTIVE: Klinefelter's syndrome affects approximately 10% of men with nonobstructive azoospermia (NOA). Recent years, using advance sperm recovery techniques increased success rate of sperm recovery from severely impaired testis. In this study, we compared testicular sperm extraction (TESE) and ICSI outcomes between chromosomally normal men with NOA and men with KS. DESIGN: A retrospective study. MATERIALS AND METHODS: Three hundred and seventy nine NOA men with normal karyotype and 106 men who were diagnosed nonmosaic KS were included in this study. All patients underwent microdissection TESE (micro TESE) operation and fresh sperm were used for ICSI. Sperm retrieval rates, ICSI results including fertilization, clinical pregnancy and abortion rates were compared between two groups. The cycles in which age of women older than 38 years and number of oocytes less than 4 were excluded to avoid the affect of female factor. The pregnancies were resulted 28 live births in KS group and 1 pregnancy is still on going. Twenty of the children tested for karyotype analysis and found normal karyotype. CONCLUSIONS: Micro TESE is a successful technique for sperm recovery in KS patients and age of the patient has an affect on sperm recovery. Although fertilizing ability of sperm in ICSI was significantly lower of in men with KS, pregnancy and abortion rates did not show any difference than NOA group. The infertility treatment of KS patients with micro TESE and ICSI is comparable as the treatment of NOA patients with normal karyotpe.