With the recent advance in the techniques of assisted reproduction, it is now possible to overcome male infertility associated with severe oligospermia or azoospermia with alternatives other than sperm donation. This is the case for some patients carrying the Klinefelter syndrome with a somatic karyotype 46,XY/47,XXY or 47,XXY. Despite a deeply defective spermatogenesis in 47,XXY patients, intracouple fertilization can be achieved with the use of intracytoplasmic sperm injection (ICSI) (1). Therefore, one should consider the risk of transmitting an aneuploidy, which would be likely to involve the sex chromosomes but could also involve the autosomes. In patients carrying a mosaic Klinefelter syndrome (46,XY/ 47,XXY), previous studies of sex chromosome segregation by sperm karyotyping (2) or fluorescent in situ hybridization (FISH) (3) or HIS (4) have shown that the percentage of hyperhaploid spermatozoa (24,XY) ranged from 0.9% to 2.1%. In subjects carrying a homogeneous somatic karyotype 47,XXY, previous data have shown variable hyperhaploidies rates, ranging from 1.36% to 25%, as well as variable sex ratios (5–7). The aim of the present work was to collect more data in order to better evaluate the risk of sex chromosome aneuploidies in the spermatozoa (and in the potential offspring) of these patients. Using multicolor FISH, the segregation of the chromosomes X, Y, and 1 was analyzed in 502 spermatozoa from a sperm sample of a first 47,XXY patient, who was a candidate for ICSI. The percentage of hyperhaploid spermatozoa 24,XY was 3.6%, which represents more than 10 times this abnormality in control donors. The sex ratio (23X/23Y) was 1.12. This work confirms that a few germinal cells with a 47,XXY chromosomal constitution are able to achieve meiosis and spermiogenesis and produce mature spermatozoa. However, a high interindividual variability seems to appear when the data from the few published studies are compared. Indeed, the presence of a remaining spermatogenesis, the sex ratio and the percentage of spermatozoa carrying a sex chromosomes hyperhaploidy are different from one 47,XXY patient to another. Therefore, a study of the sex chromosome segregation in these patients seems to be appropriate when they are candidates for ICSI. Moreover, the segregation of the autosomes might also be disturbed, but this remains to be studied. It is under current investigation in the present case.
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