因Klinefelter症候群導致之非阻塞型無精症病患使用顯微睪丸探查手術取精分析
陳嘉宏1、黃志賢1,2,3、黃奕燊1,2,3、林登龍1,2,3
臺北榮民總醫院 泌尿部1；國立陽明大學醫學院 泌尿學科2 ；書田泌尿科學研究中心3
Sperm Retrieval for NOA Patients with Klinefelter syndrome Using Micro-TESE
Chia-Hung Chen1, William J.S. Huang1,2,3, I-Shen Huang1,2,3, Alex T.L. Lin1,2,3
Department of Urology, Taipei Veterans General Hospital, Taipei, Taiwan1,
School of Medicine, National Yang-Ming University, Taipei, Taiwan2
Shu-Tien Urological Research Center, Taipei, Taiwan3
Purpose:
This study is to analyze the clinical data related to successful sperm retrieval for non-obstructive azoospermic (NOA) patients with Klinefelter syndrome (KS) via the methodology of microdissection testicular sperm extraction (micro-TESE).
Materials and Methods:
We retrospectively evaluated the results of micro-TESE of patients presenting with KS and NOA at our institute between 2010 and 2017. The clinical parameters, including age, BMI, the appearance of abnormal phenotype, testicular volume, hormone profiles, genetic testing, history of medical therapy were collected to assess the relationship with sperm retrieval outcomes.
Results:
There were 59 patients with KS collected, 2 with mosaic and 57 with non-mosaic KS. Micro-TESE was performed in all 59 patients. Sperm producing foci were allocated in testis in 23 patients (38.9%, including all 2 mosaic cases). The sperm retrieval rate is improving over years and it elevated up to 50% in the past 2 years. FSH level is the only factor showing significant difference between patients with and without sperm retrieval (Table 1). There was no other factor identified to predict a higher sperm retrieval rates (Table 2).
Conclusions:
In our KS patients presented with NOA, lower FSH levels may predict a greater rate of successful sperm retrieval. Mosaic KS (2 patients in our series) all showed positive sperm retrieval. Age, testosterone level, and testicular volume did not show statistically significant relationship with successful sperm retrieval.