[Successful microdissection testicular sperm extraction in patients with nonmosaic Klinefelter syndrome: three cases report].
OBJECTIVE
To discuss the method for patients with nonmosaic Klinefelter syndrome (KS) to father children.


METHODS
Microdissection testicular  sperm extraction (micro-TESE) was performed for three patients with nonmosaic KS in our hospital.


RESULTS
Three patients (their ranging from 23  years to 36 years), were diagnosed with azoospermia after several semen analyses. By palpation, their testis size was estimated about 3 mL,1 mL, and 4  mL, respectively. Follicle-stimulating hormone (FSH) was 37.2 IU/L, 42.2 IU/L, and 30.5 IU/L, respectively. Luteinizing hormone (LH) was 15.5 IU/L, 11.2  IU/L, and 10.1 IU/L, respectively. Testosterone was 1.2 nmol/L, 5.6 nmol/L, and 8.2 nmol/L, respectively. The volume of semen was 0.8 mL, 0.2 mL, and 0.5  mL, respectively. There was no sperm and fructose was positive. The transrectal B-bilateral showed vas deferens and seminal vesicles were not  abnormal. And all the patients had a uniform 47, XXY karyotype. During the operation, normal formation sperms were found in two patients. They only  underwent one-side micro-TESE. Active sperms were found after being cultured. The sperms were kept under cryopreservation. The other patient  underwent two-side micro-TESE. No sperm was found during the operation. After the operation, a few deformity sperms were found during the second  searching. No active sperm was found after being cultured. The sperm wasn't kept under cryopreservation.


CONCLUSIONS
Although patients with  nonmosaic KS have small testis and decreased spermatogenesis, some of them can obtain sperms by micro-TESE instead of accepting artificial  insemination by donors.
Department of Urology, Peking University Third Hospital, Beijing, China.
Lian-ming
LM
Zhao
Hui
H
Jiang
Kai
K
Hong
Jin
J
Huang
Wen-hao
WH
Tang
Jia-ming
JM
Mao
Jie
J
Qiao
Ping
P
Liu
Ying
Y
Lian
Lu-lin
LL
Ma
D000328:Adult; D006801:Humans; D007713:Klinefelter Syndrome; D008297:Male; D042282:Microdissection; D025064:Sex Chromosome Disorders / Q000235:genetics*; D053625:Sperm Retrieval; D013094:Spermatozoa; D013737:Testis / Q000033:anatomy & histology / Q000601:surgery*; D020858:Tissue and Organ Harvesting; D014997:XYY Karyotype / Q000235:genetics*; D055815:Young Adult