Fertility in men with Klinefelter's syndrome |
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| Institution: | 1. Service de Biochimie et Biologie Moléculaire, Centre de Biologie et de Pathologie Est, Hospices Civils de Lyon, Bron, France;2. Service de Médecine de la Reproduction, Hôpital Femme-Mère–Enfant, Hospices Civils de Lyon, Bron, France;3. Université Claude-Bernard Lyon 1, Lyon, France;4. Inserm U1208, 18, avenue Doyen-Lépine, 69675 Bron cedex, France;5. Service d’Urologie et de Transplantation, Hôpital Édouard-Herriot, Hospices Civils de Lyon, Lyon, France;6. CNRS UMR 5558, Laboratoire de Biométrie et Biologie Évolutive, Équipe Biostatistique-Santé, Villeurbanne, France;7. Laboratoire d’Anatomopathologie, Centre de Biologie et Pathologie Est, Hospices Civils de Lyon, Bron, France;8. Service de Génétique, Laboratoire de Cytogénétique Constitutionnelle, Centre de Biologie et de Pathologie Est, Hospices Civils de Lyon, Bron, France;9. Lyon Neuroscience Research Center, GENDEV Team, CNRS UMR 5292, INSERM U1028, UCBL1, Bron, France;10. Service de Biostatistique-Bioinformatique, Pôle Santé Publique, Hospices Civils de Lyon, Lyon, France;1. Assistance Publique–Hôpitaux de Paris, Hôpital Saint-Antoine, Centre National de Référence des Pathologies Rares de l’Insulino–Sécrétion et de l’Insulino–Sensibilité (PRISIS) et Centre National de Référence des Maladies Endocriniennes Rares de la Croissance et du Développement (CRMERCD), Service d’Endocrinologie, Diabétologie et Endocrinologie de la Reproduction, Paris, France;2. Sorbonne Université, Inserm UMR_S 938, Centre de Recherche Saint-Antoine, Institut Hospitalo–Universitaire de Cardio–métabolisme et Nutrition (ICAN), Paris, France;1. Sorbonne Université, service d’endocrinologie, diabétologie et médecine de la reproduction, hôpital St-Antoine, AP–HP, centre de référence des maladies endocriniennes rares de la croissance et du développement, 75012 Paris, France;2. Université Paris Saclay, service d’endocrinologie de le reproduction, hôpital Bicêtre, AP-HP, 94275 Bicêtre, France;1. AP–HP, IE3M, hôpital Pitié-Salpêtrière, department of endocrinology and reproductive medicine and Centre de référence des maladies endocriniennes rares de la croissance, centre de référence des pathologies gynécologiques Rares, ICAN, Paris, France;2. Sorbonne Université, Paris, France;1. Department of Gynecology-Andrology, Cliniques Universitaires Saint-Luc, Brussels 1200, Belgium;2. Andrology Lab, Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain, Brussels 1200, Belgium |
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| Abstract: | Patients with a Klinefelter syndrome (KS), defined by a 47 XXY karyotype, were long considered infertile. Testicular sperm extraction (TESE) now allows them to access fatherhood. We will present the data of studies since first experiment of TESE. Several factors influencing TESE outcome were proposed in these different studies. Among them, clinical and hormonal parameters have reported by few studies, age has been one of the most discussed prognostic factor of positive sperm retrieval rate. Data seems to show that TESE carried out before an age greater than 30 has a poorer prognosis for positive sperm retrieval. In few studies performed in younger patient, before 20 years, SRR was closed to result for 20 to 30 year old patients. Offering a TESE before 16 years old does not improve positive sperm extraction rate. In fact, the few studies carried out before the age of 16 were of poorer prognosis, most often linked to insufficient maturation of the residual gametes. In addition, androgen therapy, frequently prescribed in case of Klinefelter syndrome, did not seem to show any effect on sperm retrieval but only few studies were interested in the possible impact of this treatment. In conclusion, further studies are necessary to determine the interest of new markers to predict the chance of sperm retrieval, taking into account age, hormonal therapy. |
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| Keywords: | Klinefelter syndrome Fertility Spermatogenesis Sperm retrieval rate Androgenotheray Prognosis factors TESE age Syndrome de Klinefelter Fertilité Spermatogenèse Taux extraction de spermatozoïdes Androgénothérapie Facteurs pronostiques |
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