Outcome of ICSI using fresh and cryopreserved-thawed testicular spermatozoa in patients with non-mosaic Klinefelter's syndrome.
BACKGROUND
Recently, intracytoplasmic sperm injection (ICSI) of testicular spermatozoa retrieved surgically from patients with non-mosaic Klinefelter's syndrome resulted in several deliveries. The aim of this study was to evaluate the outcome of ICSI using fresh and cryopreserved-thawed testicular spermatozoa in these patients.


RESULTS
Following informed consent regarding the genetic risks of their potential offspring, mature testicular spermatozoa were found in five out of 12 (42%) patients who underwent testicular sperm extraction, and ICSI was performed while excess tissue was cryopreserved. The mean age of the patients was 28.7 +/- 3.6 (range 23-36 years). Their baseline FSH was elevated (mean 38.3 +/- 11.4; range 22-58 mIU/ml). All patients had small testicles of 2-4 ml in volume. The outcome of ICSI using fresh or cryopreserved-thawed testicular spermatozoa during five cycles in each group, was compared. No statistical significant difference was found in the two pronuclear fertilization rate (66 versus 58%), embryo cleavage rate (98 versus 90%) and embryo implantation rate (33.3 versus 21.4%) for fresh or cryopreserved sperm accordingly. The clinical outcome after using fresh testicular sperm included two singleton pregnancies (one delivered and one ongoing) and a triplet pregnancy resulting in a twin delivery (after reduction of an 47,XXY embryo). After using cryopreserved-thawed testicular spermatozoa, two pregnancies were obtained resulting in one delivery of twins and one early spontaneous abortion.


CONCLUSIONS
Outcome of ICSI using cryopreserved-thawed testicular spermatozoa of patients with non-mosaic Klinefelter's syndrome is comparable with that following the use of fresh spermatozoa. The genetic implications for the future offspring should be explained to the patients.
Friedler
S
S
IVF and Infertility Unit, Assaf Harofeh Medical Center, Tel Aviv University, Israel. rronel@asaf.health.gov.il
Raziel
A
A
Strassburger
D
D
Schachter
M
M
Bern
O
O
Ron-El
R
R
D000328:Adult; D002970:Cleavage Stage, Ovum; D015925:Cryopreservation; D004624:Embryo Transfer; D004622:Embryo, Mammalian / Q000502:physiology; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D006801:Humans; D007248:Infertility, Male / Q000209:etiology / Q000628:therapy; D007713:Klinefelter Syndrome / Q000150:complications*; D008297:Male; D011247:Pregnancy; D011256:Pregnancy Outcome; D020554:Sperm Injections, Intracytoplasmic; D013094:Spermatozoa / Q000502:physiology*; D013737:Testis / Q000166:cytology*; D013739:Testosterone / Q000097:blood; D016896:Treatment Outcome; D014427:Twins
D013739:Testosterone; D005640:Follicle Stimulating Hormone