title: Testicular biopsy and cryopreservation for fertility preservation of prepubertal boys with Klinefelter syndrome: a pro/con debate.
abstract: In about one-half of adult Klinefelter syndrome (KS) patients, spermatozoa can be retrieved by means of testicular biopsy (TESE). Given the expected increase in the number of diagnosed KS patients owing to the use of noninvasive prenatal testing, the probable questions of young KS patients and their parents regarding future fertility, and the fact that widespread apoptosis of spermatogonia occurs at onset of puberty, an attempt to increase the retrieval rates at TESE above those found in adult KS men by undertaking preservation techniques peripubertally has been initiated. To date, however, only a limited number of KS adolescents have been examined, demonstrating no increases in the chances of finding sperm. Furthermore, spermatogonial stem cell and testicular tissue freezing techniques, as well as in vitro maturation strategies, require further validation. Given these controversies, banking testicular tissue from prepubertal KS boys should be performed only in a research framework.
authors.affiliation: Division of Pediatric Endocrinology, Department of Pediatrics, UZ Brussel, Jette, Belgium. Electronic address: inge.gies@uzbrussel.be.
authors.forename: Inge
authors.initials: I
authors.lastname: Gies
authors.affiliation: Department of Urology, Boston University School of Medicine, Boston, Massachusetts.
authors.forename: Robert
authors.initials: R
authors.lastname: Oates
authors.affiliation: Division of Pediatric Endocrinology, University Hospital Brussels, Jette, Belgium; Biology of the Testis Research Group, Department of Embryology and Genetics, Vrije Universiteit Brussel, Jette, Belgium.
authors.forename: Jean
authors.initials: J
authors.lastname: De Schepper
authors.affiliation: Biology of the Testis Research Group, Department of Embryology and Genetics, Vrije Universiteit Brussel, Jette, Belgium; Center for Reproductive Medicine, Jette, Belgium.
authors.forename: Herman
authors.initials: H
authors.lastname: Tournaye
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001706:Biopsy; D002648:Child; D015925:Cryopreservation; D005298:Fertility; D059247:Fertility Preservation / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D007248:Infertility, Male / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D007713:Klinefelter Syndrome / Q000150:complications* / Q000175:diagnosis / Q000235:genetics; D008297:Male; D011237:Predictive Value of Tests; D011627:Puberty; D012307:Risk Factors; D012662:Semen Preservation / Q000009:adverse effects / Q000379:methods*; D053625:Sperm Retrieval; D013091:Spermatogenesis; D013094:Spermatozoa / Q000473:pathology*; D013737:Testis / Q000473:pathology*; D055815:Young Adult
keywords: Klinefelter; fertility preservation; prepubertal