Sperm retrieval rates in non-mosaic Klinefelter patients undergoing testicular sperm extraction: What expectations do we have in the real-life setting?
| Autor: | Alessandro Franceschelli, Francesco Montorsi, Antonino Saccà, Landon Trost, Luigi Rolle, Mirko Preto, Andrea Salonia, Eduard Ruiz-Castañé, Lluís Bassas-Arnau, Fabrizio I. Scroppo, Franco Gadda, Carlo Ceruti, Josvany Sánchez-Curbelo, M. Sibona, Giorgio Gentile, Franco Palmisano, Joaquim Sarquella-Geli, Marco Falcone, Fulvio Colombo, Massimiliano Timpano, Paolo Capogrosso, Paolo Gontero, Emanuele Montanari, Luca Boeri |
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| Přispěvatelé: | Boeri, L., Palmisano, F., Preto, M., Sibona, M., Capogrosso, P., Franceschelli, A., Ruiz-Castane, E., Sarquella-Geli, J., Bassas-Arnau, L., Scroppo, F. I., Sacca, A., Gentile, G., Falcone, M., Timpano, M., Ceruti, C., Gadda, F., Trost, L., Colombo, F., Rolle, L., Gontero, P., Montorsi, F., Sanchez-Curbelo, J., Salonia, A., Montanari, E. |
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Urology Endocrinology Diabetes and Metabolism medicine.medical_treatment predictor sperm retrieval Intracytoplasmic sperm injection male infertility Male infertility 03 medical and health sciences Young Adult 0302 clinical medicine Endocrinology medicine Humans Klinefelter syndrome azoospermia predictors Infertility Male Retrospective Studies Azoospermia 030219 obstetrics & reproductive medicine Obstetrics business.industry Retrospective cohort study Middle Aged medicine.disease Testicular sperm extraction Reproductive Medicine Cohort business Cohort study |
| Zdroj: | Andrology r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau instname |
| ISSN: | 2047-2919 |
| Popis: | Background A recent meta-analysis (Human Reproduction Update 23, 2017 and 265) reported positive sperm retrieval rates (SRR) in 50% of patients with Klinefelter syndrome (KS) undergoing testicular sperm extraction (TESE). However, these results do not reflect the rates of SR that we observe in clinical practice. We assessed the rate and potential predictors of SR in Klinefelter patients in the real-life setting. Materials and Methods We reviewed clinical data of 103 KS men who underwent TESE between 08/2008 and 03/2019 at five tertiary referral Andrology centers. Patients underwent testis ultrasound, hormonal evaluation, and genetic testing. All patients were azoospermic based on the 2010 WHO reference criteria. Conventional TESE (cTESE) or microsurgical TESE (mTESE) was performed based on the surgeon's preference. We used descriptive statistics and logistic regression models to describe the whole cohort. Results Median (IQR) patient's age was 32 (24-37) years. Baseline serum FSH and total testosterone levels were 29.5 (19.9-40.9) mUI/mL and 3.8 (2.5-11.0) ng/mL, respectively. Conventional TESE and mTESE were performed in 38 (36.5%) and 65 (63.5%) men, respectively. The sperm retrieval rate was 21.4% (22/103 men). Fifteen patients used spermatozoa for ICSI and five ended in live birth children. Patients with positive SR were similar to those with a negative TESE in terms of clinical, hormonal, and procedural parameters (all P > .05). Logistic regression analyses confirmed the lack of association between clinical, hormonal, and procedural parameters with SR outcome. Discussion Given the conflicting results in the literature regarding SRR in KS, patients should be carefully counseled regarding TESE outcomes based on data from published literature and local results. Conclusions In the real-life setting, we observed a lower SRR (21.4%) than that reported in meta-analyses in our cohort of KS patients. No associations between clinical, hormonal, and procedural variables with TESE success were found. |
| Databáze: | OpenAIRE |
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