早期睪丸取精對無精蟲症合併克林菲特氏症候群男性有較高成功率
戴大堯、鄭裕生、林永明
國立成功大學附設醫院 泌尿部
Early testicular sperm retrieval in azoospermic men with Klinefelter’s syndrome may increase successful rate
Ta-Yao Tai, Yu-Sheng Cheng, Yung-Ming Lin
Department of Urology, College medicine and Hospital, National Cheng Kung University, Tainan, Taiwan
Objective: To study the clinical characteristics and sperm retrieval outcome in azoospermic men with non-mosaic Klinefelter’s syndrome (KS)
Materials and Methods: Thirty-three azospermic men with non-mosaic KS undergoing testicular sperm extraction (TESE) or microTESE were retrospectively reviewed. Their medical history, physical examination findings, testicular volume, serum hormone parameters and sperm retrieval outcome were analyzed.
Results: Increased serum FSH and LH levels as well as decreased testosterone levels were noted in the majority of the patients. All patients had bilateral testicular atrophy (less than 15 ml for each testicle). Five patients were between the age of 18 to 29 years at the time of operation, while the other 28 patients were age 30 years or older. Three out of five (60%) younger patients had successful TESE and nine out of 28 (32.1%) older patients met with success (P = 0.327). The overall successful sperm retrieval rate was 36.4% (12/33). For 12 patients with successful TESE, the histopathogical findings were hypospermatogenesis in 8, late maturation arrest (MA) in 2, early MA 1 and Sertoli cell-only syndrome (SCOS) in 1. For 21 patients with failed TESE, there were hypospermatogenesis in 1, early MA in 1 and SCOS in 19.
Conclusions: TESE is an effective sperm retrieval technique in men with non-mosaic KS, and successful sperm retrieval might decrease with age.