Comparison of Sperm Retrieval and Intracytoplasmic Sperm Injection Outcome in Patients With and Without Klinefelter Syndrome

Abstract

To evaluate microsurgical testicular sperm extraction (micro-TESE) and intracytoplasmic sperm injection (ICSI) treatment in patients with non-mosaic Klinefelter syndrome (KS). We retrospectively evaluated the micro-TESE/ICSI performance in 134 patients with classic KS and 537 men with nonobstructive azoospermia (NOA) and normal karyotype referred to Royan Institute between 2009 and 2011. The patients were divided into 2 groups according to micro-TESE outcome. Several factors, including patients' age, level of follicle stimulating hormone (FSH), luteinizing hormone (LH), and testosterone, were compared between the 2 groups. Sperm retrieval rate by micro-TESE in the KS and control groups were 28.4% (38/134) and 22.2% (119/537), respectively. In the KS group, the mean age of patients with successful sperm retrieval of spermatozoa was significantly lower than those with negative results (30.0 ± 0.65 vs 33.68 ± 0.6 year, P= .001) and comparison of laboratory parameters between the 2 groups showed that the level of testosterone was significantly higher in patients with successful sperm retrieval (3.4 ± 0.48 vs 2.33 ± 0.23 ng/mL, P<.001). The fertilization rate was significantly higher in the KS group than the control group (28% vs 21%, P= .038). Also, live birth rate per embryo transfer was higher in the KS group, but it was not significant (13% vs 3%, P= .05). This study of sperm recovery and ICSI outcome in men with and without KS shows that micro-TESE/ICSI is a successful intervention for the majority of men with KS.