title: Comparison of sperm retrieval and intracytoplasmic sperm injection outcome in patients with and without Klinefelter syndrome.
abstract: OBJECTIVE
  To evaluate microsurgical testicular sperm extraction (micro-TESE) and intracytoplasmic sperm injection (ICSI) treatment in patients with non-mosaic Klinefelter syndrome (KS).
  
  
  METHODS
  We retrospectively evaluated the micro-TESE/ICSI performance in 134 patients with classic KS and 537 men with nonobstructive azoospermia (NOA) and normal karyotype referred to Royan Institute between 2009 and 2011. The patients were divided into 2 groups according to micro-TESE outcome. Several factors, including patients' age, level of follicle stimulating hormone (FSH), luteinizing hormone (LH), and testosterone, were compared between the 2 groups.
  
  
  RESULTS
  Sperm retrieval rate by micro-TESE in the KS and control groups were 28.4% (38/134) and 22.2% (119/537), respectively. In the KS group, the mean age of patients with successful sperm retrieval of spermatozoa was significantly lower than those with negative results (30.0 ± 0.65 vs 33.68 ± 0.6 year, P = .001) and comparison of laboratory parameters between the 2 groups showed that the level of testosterone was significantly higher in patients with successful sperm retrieval (3.4 ± 0.48 vs 2.33 ± 0.23 ng/mL, P <.001). The fertilization rate was significantly higher in the KS group than the control group (28% vs 21%, P = .038). Also, live birth rate per embryo transfer was higher in the KS group, but it was not significant (13% vs 3%, P = .05).
  
  
  CONCLUSIONS
  This study of sperm recovery and ICSI outcome in men with and without KS shows that micro-TESE/ICSI is a successful intervention for the majority of men with KS.
authors.affiliation: Department of Andrology at Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.
authors.forename: Marjan
authors.initials: M
authors.lastname: Sabbaghian
authors.affiliation: Department of Andrology at Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.
authors.forename: Tahereh
authors.initials: T
authors.lastname: Modarresi
authors.affiliation: Department of Andrology at Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.
authors.forename: Hani
authors.initials: H
authors.lastname: Hosseinifar
authors.affiliation: Department of Andrology at Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.
authors.forename: Jalil
authors.initials: J
authors.lastname: Hosseini
authors.affiliation: Department of Andrology at Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.
authors.forename: Faramarz
authors.initials: F
authors.lastname: Farrahi
authors.affiliation: Department of Andrology at Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.
authors.forename: Farid
authors.initials: F
authors.lastname: Dadkhah
authors.affiliation: Department of Epidemiology and Reproductive Health at Reproductive Epidemiology Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Chehrazi
authors.affiliation: Department of Epidemiology and Reproductive Health at Reproductive Epidemiology Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.
authors.forename: Gholamreza
authors.initials: G
authors.lastname: Khalili
authors.affiliation: Department of Andrology at Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran; Department of Urology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. Electronic address: masadighi@gmail.com.
authors.forename: Mohammad Ali
authors.initials: MA
authors.lastname: Sadighi Gilani
mesh_terms: D000328:Adult; D006801:Humans; D007248:Infertility, Male / Q000209:etiology; D007713:Klinefelter Syndrome / Q000150:complications; D008297:Male; D012189:Retrospective Studies; D020554:Sperm Injections, Intracytoplasmic; D053625:Sperm Retrieval; D016896:Treatment Outcome