title: Adult onset of declining spermatogenesis in a man with nonmosaic Klinefelter's syndrome.
abstract: OBJECTIVE
  To examine an unusual case of Klinefelter's syndrome.
  
  
  METHODS
  Case report.
  
  
  METHODS
  An infertility clinic at a private hospital.
  
  
  METHODS
  A patient with nonmosaic Klinefelter's syndrome who had had a child with his ex-wife without artificial reproductive technologies.
  
  
  METHODS
  Karyotyping with peripheral blood lymphocytes, microdissection testicular sperm extraction, and intracytoplasmic sperm injection (ICSI).
  
  
  METHODS
  Sperm count and testicular histopathology.
  
  
  RESULTS
  Semen analysis revealed severe oligoasthenozoospermia. Intracytoplasmic sperm injection using ejaculated spermatozoa was performed, and successful pregnancy and delivery were achieved. Two years later, multiple semen analyses revealed azoospermia. Microdissection testicular sperm extraction was performed, and motile sperm were successfully retrieved. Unfortunately, the first cycle of ICSI using testicular sperm failed. Testicular histopathology was compatible with decreased spermatogenesis.
  
  
  CONCLUSIONS
  This is a case of a man with nonmosaic Klinefelter's syndrome who exhibited progressive decline of spermatogenesis. This case suggests the merit of early sperm retrieval and cryopreservation for future management of infertility in Klinefelter's syndrome.
authors.affiliation: Department of Urology, Kurashiki Central Hospital, Okayama, Japan. ichioka@mq.0038.net
authors.forename: Kentaro
authors.initials: K
authors.lastname: Ichioka
authors.forename: Noriaki
authors.initials: N
authors.lastname: Utsunomiya
authors.forename: Naoki
authors.initials: N
authors.lastname: Kohei
authors.forename: Nobufumi
authors.initials: N
authors.lastname: Ueda
authors.forename: Koji
authors.initials: K
authors.lastname: Inoue
authors.forename: Akito
authors.initials: A
authors.lastname: Terai
mesh_terms: D000328:Adult; D017668:Age of Onset; D006801:Humans; D007248:Infertility, Male / Q000175:diagnosis*; D007713:Klinefelter Syndrome / Q000175:diagnosis*; D008297:Male; D009030:Mosaicism; D013076:Sperm Count; D013091:Spermatogenesis; D013094:Spermatozoa / Q000002:abnormalities*