[Successful microdissection testicular sperm extraction in patients with nonmosaic Klinefelter syndrome: three cases...

To discuss the method for patients with nonmosaic Klinefelter syndrome (KS) to father children.

Microdissection testicular sperm extraction (micro-TESE) was performed for three patients with nonmosaic KS in our hospital.

Three patients (their ranging from 23 years to 36 years), were diagnosed with azoospermia after several semen analyses. By palpation, their testis size was estimated about 3 mL,1 mL, and 4 mL, respectively. Follicle-stimulating hormone (FSH) was 37.2 IU/L, 42.2 IU/L, and 30.5 IU/L, respectively. Luteinizing hormone (LH) was 15.5 IU/L, 11.2 IU/L, and 10.1 IU/L, respectively. Testosterone was 1.2 nmol/L, 5.6 nmol/L, and 8.2 nmol/L, respectively. The volume of semen was 0.8 mL, 0.2 mL, and 0.5 mL, respectively. There was no sperm and fructose was positive. The transrectal B-bilateral showed vas deferens and seminal vesicles were not abnormal. And all the patients had a uniform 47, XXY karyotype. During the operation, normal formation sperms were found in two patients. They only underwent one-side micro-TESE. Active sperms were found after being cultured. The sperms were kept under cryopreservation. The other patient underwent two-side micro-TESE. No sperm was found during the operation. After the operation, a few deformity sperms were found during the second searching. No active sperm was found after being cultured. The sperm wasn't kept under cryopreservation.

Although patients with nonmosaic KS have small testis and decreased spermatogenesis, some of them can obtain sperms by micro-TESE instead of accepting artificial insemination by donors.