P–085 Sperm retrieval after microdissection testicular sperm extraction (micro-TESE) and pregnancy outcomes of intracytoplasmic sperm injection (ICSI) in men with Klinefelter syndrome

Abstract

Abstract Study question What are the sperm retrieval rate and ICSI outcomes in azoospermic men with Klinefelter syndrome (KS)? Summary answer In men with KS, a sperm retrieval rate of 51.3% after the first attempt micro-TESE, and 4 live births after ICSI were observed. What is known already: Klinefelter syndrome (KS) is encountered in 10% of men with azoospermia. Micro-TESE is presently used to treat infertility for KS patients with nonobstructive azoospermia. The retrieved sperms can be used for ICSI. Study design, size, duration: From June 2019 to July 2020, 39 azoospermic patients with KS were examined for the presence of testicular spermatozoa. Participants/materials, setting, methods: Participants were recruited from couples attending the Andrology and Fertility Hospital of Hanoi Vietnam, for infertility treatment. Micro-TESE was performed to extract testicular tissue. After retrieval, ICSI was used with fresh sperm. Main results and the role of chance: The sperm retrieval rate of first attempt micro-TESE in KS men was 51.3% (20/39). Logistic regression analysis showed patient age did not affect the sperm retrieval rate of micro-TESE (OR 0.99, 95% CI 0.88 - 1.11). Similarly, no association was observed between serum FSH, LH, testosterone level, and testicular volume with the success of sperm retrieval. The fertilization rate after ISCI in patients with retrieved sperm was 60% (12/20). Clinical pregnancy and ongoing pregnancy rates were 50% (10/20) and 40% (8/20). There were 4 live births. No sufficient data were available to test the effect of clinical or biological parameters on ICSI outcomes. Limitations, reasons for caution Our data rely on a cohort of KS patients attending a single fertility clinic. The sample size did not allow regression analysis for any ICSI outcome. Wider implications of the findings: Micro-TESE is helpful in retrieving sperm in azoospermia KS patients with sperm retrieval rate reaching 50%. ICSI following micro-TESE can lead to an ongoing pregnancy rate of 40% with some result in live births. The outcome of micro-TESE is independent of any clinical or biochemical parameters tested. Trial registration number Not applicable