Adult onset of declining spermatogenesis in a man with nonmosaic Klinefelter's syndrome.
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.
Ichioka
Kentaro
K
Department of Urology, Kurashiki Central Hospital, Okayama, Japan. ichioka@mq.0038.net
Utsunomiya
Noriaki
N
Kohei
Naoki
N
Ueda
Nobufumi
N
Inoue
Koji
K
Terai
Akito
A
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*