Introduction: Klinefelter syndrome (KF) is the most common chromosomal disorder associated with male hypogonadism and infertility. Parenthood can be achieved in men with KF by intracytoplasmic sperm injection (ICSI) using testicular sperm.
Aim: To evaluate surgical sperm retrieval rate (SSR) in KF patients in Qatar and to investigate methods to improve SSR in this group of patients.
Patients and methods: This is a retrospective study where all the medical records of KF patients who underwent SSR for ICSI, in our center in the past 14 years, were reviewed.
Results: 41 patients were included. 23 underwent conventional testicular sperm extraction (TESE) and 18 underwent microsurgical TESE (Micro-TESE). SSR was significantly higher in the Micro-TESE group than TESE group (33.3% versus 0% respectively). In the Micro-TESE group 14 patients received hormonal stimulation prior to Micro-TESE and 4 patients did not receive. SSR was 42.9% versus 0% in both groups respectively. Within the 14 patients who received hormonal stimulation 8 patients received aromatase inhibitors while the other 6 received other hormonal stimulation. SSR was 62.5% versus 16.7% in both groups respectively.
Conclusion: SSR in KF patients is significantly more when using hormonal stimulation by aromatase inhibitors followed by microsurgical testicular sperm extraction.