PD09-06 FERTILITY IN ADOLESCENTS WITH KLINEFELTER SYNDROME – A SURVEY OF CURRENT CLINICAL PRACTICE

Abstract

You have accessJournal of UrologyInfertility: Epidemiology & Evaluation I1 Apr 2018PD09-06 FERTILITY IN ADOLESCENTS WITH KLINEFELTER SYNDROME – A SURVEY OF CURRENT CLINICAL PRACTICE Andrew Zganjar, Ajay Nangia, Rebecca Sokol, Anna Ryabets, Anthony Thomas, and Mary Samplaski Andrew ZganjarAndrew Zganjar More articles by this author , Ajay NangiaAjay Nangia More articles by this author , Rebecca SokolRebecca Sokol More articles by this author , Anna RyabetsAnna Ryabets More articles by this author , Anthony ThomasAnthony Thomas More articles by this author , and Mary SamplaskiMary Samplaski More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.603AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The optimal fertility preservation protocols in adolescents with Klinefelter Syndrome (KS) are still being determined. We sought to survey which specialties are treating these patients, and the currently executed practices regarding fertility and andrology care in these patients. METHODS A 24 question electronic survey was developed to elicit practitioner background/expertise and management practices regarding fertility preservation in adolescent males with KS. The survey was distributed to members of the Society for the Study of Male Reproduction, Pediatric Endocrine Society, and Endocrine Society. Survey responses were compiled for each question with additional analysis by individual medical specialties. RESULTS We received 232 responses: 60 (26%) pediatric endocrinologists (PE), 133 (57%) adult endocrinologists (AE), and 39 (17%) urologists. 68% of physicians were in the academic setting, 63% were in practice for >10 years, and 65% received formal training in KS. ″Past clinical experience″ and ″current literature″ guided management decisions for most providers. Table 1 summarizes responses regarding sperm banking and testicular biopsy. The majority of the respondents agreed that testicular biopsy should be offered if no sperm was found in the ejaculate; however, the optimal age for the procedure varied among specialists. Most agreed that sperm extraction shouldn′t be done in boys < 8 years of age. There was variation in responses regarding the need for psychotherapy care prior to undergoing invasive fertility treatments, as well as the optimal timing for starting testosterone replacement therapy (TRT). Rising gonadotropin levels (15%), testosterone levels (15%), and clinical symptoms of hypogonadism (28%) were commonly cited reasons for TRT initiation. Most AE (60%) and urologists (65%) did not agree with starting infants on TRT; however, most PE (65%) believed it was indicated if/when patients had a micropenis. CONCLUSIONS Clinical practices for fertility preservation in adolescents with KS vary greatly within and between the specialties caring for these patients. These findings may help guide future research and highlight the importance of establishing clinical practice guidelines. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e224 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Andrew Zganjar More articles by this author Ajay Nangia More articles by this author Rebecca Sokol More articles by this author Anna Ryabets More articles by this author Anthony Thomas More articles by this author Mary Samplaski More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...