Objective: Klinefelter syndrome (KS) represents a sex chromosome anomaly observed in
approximately 1 in 500–600 phenotypic males. It is observed in 3% of infertile males and up
to 11.9% of azoospermic males. KS manifests in either non-mosaic (47, XXY) or mosaic (47,
XXY/46, XY) forms, with 85% of cases presenting as the non-mosaic 47, XXY karyotype. The
average rate of surgical sperm retrieval in patients with KS is around 50%, ranging from 28% to
69%. In this study, we aimed to present the outcomes of microscopic testicular sperm extraction
(micro-TESE) in patients with non-mosaic KS.
Material and Methods: The results of 61 patients diagnosed with KS, who presented to the
Harran University Urology Clinic with azoospermia between 2017 and 2024, were retrospectively
reviewed. Hormonal assessments, including follicle-stimulating hormone (FSH), luteinizing
hormone (LH), estradiol, and total testosterone (TT), were conducted for all patients, and
their partners underwent gynecological evaluations for infertility. Testicular dimensions were
recorded via scrotal ultrasonography. Patients were categorized into TESE-positive and TESEnegative groups, and parameters were compared between these groups.
Results: The mean age of the patients was 29.0±5.1 years, and their mean infertility duration
was 5.9±4.1 years. The sperm retrieval rate was 29.5% (n=18). Mean levels of FSH, LH,
prolactin, estradiol, and TT were 44.9 IU/L, 23.3 IU/L, 10 nmol/L, 31.4 pmol/dL, and 219 ng/
dL, respectively. Sperm was retrieved in 18 patients (29.5%), while no sperm was obtained in
43 (70.5%). No significant correlation was observed between patient age, testicular size, serum
levels of FSH, LH, prolactin, estradiol, and TT, and sperm retrieval rates when comparing the
TESE-positive and TESE-negative groups (P>0.005).
Conclusion: In patients with non-mosaic KS, hormonal parameters, age, and infertility duration
were not found to be significant predictors of the success of micro-TESE in sperm retrieval.
Keywords: klinefelter syndrome,, microscopic testicular sperm extraction, azoospermia
Abstract
Objective: Klinefelter syndrome (KS) represents a sex chromosome anomaly observed in
approximately 1 in 500–600 phenotypic males. It is observed in 3% of infertile males and up
to 11.9% of azoospermic males. KS manifests in either non-mosaic (47, XXY) or mosaic (47,
XXY/46, XY) forms, with 85% of cases presenting as the non-mosaic 47, XXY karyotype. The
average rate of surgical sperm retrieval in patients with KS is around 50%, ranging from 28% to
69%. In this study, we aimed to present the outcomes of microscopic testicular sperm extraction
(micro-TESE) in patients with non-mosaic KS.
Material and Methods: The results of 61 patients diagnosed with KS, who presented to the
Harran University Urology Clinic with azoospermia between 2017 and 2024, were retrospectively
reviewed. Hormonal assessments, including follicle-stimulating hormone (FSH), luteinizing
hormone (LH), estradiol, and total testosterone (TT), were conducted for all patients, and
their partners underwent gynecological evaluations for infertility. Testicular dimensions were
recorded via scrotal ultrasonography. Patients were categorized into TESE-positive and TESEnegative groups, and parameters were compared between these groups.
Results: The mean age of the patients was 29.0±5.1 years, and their mean infertility duration
was 5.9±4.1 years. The sperm retrieval rate was 29.5% (n=18). Mean levels of FSH, LH,
prolactin, estradiol, and TT were 44.9 IU/L, 23.3 IU/L, 10 nmol/L, 31.4 pmol/dL, and 219 ng/
dL, respectively. Sperm was retrieved in 18 patients (29.5%), while no sperm was obtained in
43 (70.5%). No significant correlation was observed between patient age, testicular size, serum
levels of FSH, LH, prolactin, estradiol, and TT, and sperm retrieval rates when comparing the
TESE-positive and TESE-negative groups (P>0.005).
Conclusion: In patients with non-mosaic KS, hormonal parameters, age, and infertility duration
were not found to be significant predictors of the success of micro-TESE in sperm retrieval.
Keywords: klinefelter syndrome,, microscopic testicular sperm extraction, azoospermia