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Turkish Journal of Reproductive Medicine and Surgery

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ORİJİNAL ARAŞTIRMALAR
Klinefelter Sendromlu Olgularda Mikro-Tese ve Icsı ile Canlı Doğum Sonuçları
Live Birth Following Icsi Using Testicular Spermatozoa Retrieved By Micro- Tese in Males with Klinefelter Syndrome
Received Date : 02 Jun 2020
Accepted Date : 16 Dec 2020
Available Online : 03 Feb 2021
Özet PDF Benzer Makaleler
Oğuz EKMEKÇİOĞLUa, Sina ARİAb, Yılmaz ŞAHİNb, M. Ercan AYGENb, Arzu YURCİc Semih Z. ULUDAĞb, Doğan DURMAZERc, Emre Can AKINSALa
aErciyes Üniversitesi Tıp Fakültesi, Üroloji ABD, Kayser, TÜRKİYE bErciyes Üniversitesi Tıp Fakültesi, Kadın Hastalıkları ve Doğum ABD, Tüp Bebek Ünitesi, Kayseri, TÜRKİYE cKayseri Memorial Hastanesi, Tüp Bebek Merkezi, Kayseri, TÜRKİYE
Doi: 10.24074/tjrms.2020-75035 - Makale Dili: TR
TJRMS. 2020;4(1):1-7
ÖZET
Amaç: Klinefelter Sendromuna bağlı azoospermide mikro-testiküler sperm ekstraksiyonu (mikro-TESE) ve intraspermik sperm injeksiyonu (ICSI) ile gebelik ve canlı doğum sonuçlarının değerlendirilmesi Gereç ve Yöntem: Bu retrospektif çalışmaya Ocak 2005 ile Ocak 2019 tarihleri arasında Erciyes Üniversitesi Tıp Fakültesi ve Memorial Kayseri Hastanesi tüp bebek ünitelerine başvuran Klinefelter Sendromlu olgular alındı. Mikro-TESE işlemi 92 olguda uygulandı. Sperm elde edilebilen ve ICSI uygulanan 25 olgu vardı ve bu olgularda işlem sonrası gebelik ve canlı doğum oranları değerlendirildi. Bulgular: Sperm elde edilen olgu oranı %27.2 idi ve 25 hastaya 26 mikro-TESE işlemi yapıldı. Bir hastaya iki ICSI olmak üzere toplam 26 ICSI siklusu yapıldı, 25 olgunun üçüne embriyo transferi yapılamadı. Bir hastada biyokimyasal gebelik, dokuz olguda klinik gebelik (%36), bir olguda abortus oldu. Dokuz klinik gebeliğin 8’i (%88.9) canlı doğuma ulaştı. Transfer yapılabilen 22 olgunun sekizi (%36.4) canlı bebek sahibi oldu. Sonuçlar: Serimizde mikro-TESE ile sperm bulunabilen Klinefelter Sendromlu olguların üçte biri canlı çocuğa sahip oldular.
Anahtar Kelimeler: Azoospermi; klinefelter sendromu; TESE; İVF
ABSTRACT
Objective: To evaluate the clinical outcomes of intracytoplasmic sperm injection (ICSI) using testicular spermatozoa retrieved by microdissection TESE in azoospermic men with Klinefelter syndrome. Material and Methods: In this retrospective study, the data of males with Klinefelter Syndrome who underwent micro-TESE between January 2005 and January 2019 at Erciyes University Faculty of Medicine and Memorial Kayseri Hospital In Vitro Fertilization Centers. were evaluated. In 92 males micro-TESE has been performed. In 25 males sperm could be retrieved and in these males results of ICSI, pregnancy and take home baby ratios were evaluated. Results: In 25 males in whom sperm could be retrieved 26 ICSI procedures were performed. Embryo transfers could be performed in 23 couples. In 1 couple biochemical pregnancy, In 9 out of 25 couples (36%) clinical pregnancies could be obtained. In one couple one miscarriage occurred. In 9 clinical pregnancies 8 (88.9%) resulted in live births. In 23 couples in whom embrio tranfer could be achieved, 8 (34.8%) resulted in live births. Conclusion: In our series, Klinefelter males with sperm via micro-TESE one third could achieve live births.
Keywords: Azoospermia; klinefelter syndrome, TESE; IVF
REFERANSLAR
  1. Lanfranco F, Kamischke A, Zitzmann M, Nieschlag E. Klinefelter's syndrome. Lancet (London, England). 2004;364(9430):273-83.[Crossref] 
  2. Foresta C, Galeazzi C, Bettella A, Stella M, Scandellari C. High incidence of sperm sex chromosomes aneuploidies in two patients with Klinefelter's syndrome. The Journal of clinical endocrinology and metabolism. 1998;83(1):203-5.[Crossref] [PubMed] 
  3. Vernaeve V, Staessen C, Verheyen G, Van Steirteghem A, Devroey P, Tournaye H. Can biological or clinical parameters predict testicular sperm recovery in 47,XXY Klinefelter's syndrome patients? Human reproduction (Oxford, England). 2004;19(5):1135-9.[Crossref] [PubMed] 
  4. Aksglaede L, Juul A. Testicular function and fertility in men with Klinefelter syndrome: a review. European journal of endocrinology. 2013;168(4):R67-76.[Crossref] [PubMed] 
  5. Aksglaede L, Andersson AM, Jorgensen N, Jensen TK, Carlsen E, McLachlan RI, et al. Primary testicular failure in Klinefelter's syndrome: the use of bivariate luteinizing hormone-testosterone reference charts. Clinical endocrinology. 2007;66(2):276-81.[Crossref] [PubMed] 
  6. Herlihy AS, Halliday JL, Cock ML, McLachlan RI. The prevalence and diagnosis rates of Klinefelter syndrome: an Australian comparison. The Medical journal of Australia. 2011;194(1):24-8.[Crossref] [PubMed] 
  7. Foresta C, Galeazzi C, Bettella A, Marin P, Rossato M, Garolla A, et al. Analysis of meiosis in intratesticular germ cells from subjects affected by classic Klinefelter's syndrome. The Journal of clinical endocrinology and metabolism. 1999;84(10):3807-10.[Crossref] [PubMed] 
  8. Forti G, Corona G, Vignozzi L, Krausz C, Maggi M. Klinefelter's syndrome: a clinical and therapeutical update. Sexual development : genetics, molecular biology, evolution, endocrinology, embryology, and pathology of sex determination and differentiation. 2010;4(4-5):249-58.[Crossref] [PubMed] 
  9. Palermo G, Joris H, Devroey P, Van Steirteghem AC. Pregnancies after intracytoplasmic injection of single spermatozoon into an oocyte. Lancet (London, England). 1992;340(8810):17-8.[Crossref] 
  10. Palermo GD, Schlegel PN, Sills ES, Veeck LL, Zaninovic N, Menendez S, et al. Births after intracytoplasmic injection of sperm obtained by testicular extraction from men with nonmosaic Klinefelter's syndrome. The New England journal of medicine. 1998;338(9):588-90.[Crossref] [PubMed] 
  11. Van Steirteghem AC, Liu J, Joris H, Nagy Z, Janssenswillen C, Tournaye H, et al. Higher success rate by intracytoplasmic sperm injection than by subzonal insemination. Report of a second series of 300 consecutive treatment cycles. Human reproduction (Oxford, England). 1993;8(7):1055-60.[Crossref] [PubMed] 
  12. Van Steirteghem AC, Nagy Z, Joris H, Liu J, Staessen C, Smitz J, et al. High fertilization and implantation rates after intracytoplasmic sperm injection. Human reproduction (Oxford, England). 1993;8(7):1061-6.[Crossref] [PubMed] 
  13. Okada H, Goda K, Yamamoto Y, Sofikitis N, Miyagawa I, Mio Y, et al. Age as a limiting factor for successful sperm retrieval in patients with nonmosaic Klinefelter's syndrome. Fertility and sterility. 2005;84(6):1662-4.[Crossref] [PubMed] 
  14. Corona G, Pizzocaro A, Lanfranco F, Garolla A, Pelliccione F, Vignozzi L, et al. Sperm recovery and ICSI outcomes in Klinefelter syndrome: a systematic review and meta-analysis. Human reproduction update. 2017;23(3):265-75.[Crossref] [PubMed] 
  15. Oates RD. The genetic basis of male reproductive failure. The Urologic clinics of North America. 2008;35(2):257-70, ix.[Crossref] [PubMed] 
  16. Tournaye H, Staessen C, Liebaers I, Van Assche E, Devroey P, Bonduelle M, et al. Testicular sperm recovery in nine 47,XXY Klinefelter patients. Human reproduction (Oxford, England). 1996;11(8):1644-9.[Crossref] [PubMed] 
  17. Levron J, Aviram-Goldring A, Madgar I, Raviv G, Barkai G, Dor J. Sperm chromosome analysis and outcome of IVF in patients with non-mosaic Klinefelter's syndrome. Fertility and sterility. 2000;74(5):925-9.[Crossref] 
  18. Schiff JD, Palermo GD, Veeck LL, Goldstein M, Rosenwaks Z, Schlegel PN. Success of testicular sperm extraction [corrected] and intracytoplasmic sperm injection in men with Klinefelter syndrome. The Journal of clinical endocrinology and metabolism. 2005;90(11):6263-7.[Crossref] [PubMed] 
  19. Koga M, Tsujimura A, Takeyama M, Kiuchi H, Takao T, Miyagawa Y, et al. Clinical comparison of successful and failed microdissection testicular sperm extraction in patients with nonmosaic Klinefelter syndrome. Urology. 2007;70(2):341-5.[Crossref] [PubMed] 
  20. Boeri L, Palmisano F, Preto M, Sibona M, Capogrosso P, Franceschelli A, et al. Sperm retrieval rates in non-mosaic Klinefelter patients undergoing testicular sperm extraction: What expectations do we have in the real-life setting? Andrology. 2020.[Crossref] 
  21. Vicdan K, Akarsu C, Sozen E, Buluc B, Vicdan A, Yilmaz Y, et al. Outcome of intracytoplasmic sperm injection using fresh and cryopreserved-thawed testicular spermatozoa in 83 azoospermic men with Klinefelter syndrome. The journal of obstetrics and gynaecology research. 2016;42(11):1558-66.[Crossref] [PubMed] 
  22. Ozer C, Caglar Aytac P, Goren MR, Toksoz S, Gul U, Turunc T. Sperm retrieval by microdissection testicular sperm extraction and intracytoplasmic sperm injection outcomes in nonobstructive azoospermic patients with Klinefelter syndrome. Andrologia. 2018.[Crossref] [PubMed] 
  23. Gies I, Oates R, De Schepper J, Tournaye H. Testicular biopsy and cryopreservation for fertility preservation of prepubertal boys with Klinefelter syndrome: a pro/con debate. Fertility and sterility. 2016;105(2):249-55.[Crossref] [PubMed] 
  24. Plotton I, Giscard d'Estaing S, Cuzin B, Brosse A, Benchaib M, Lornage J, et al. Preliminary results of a prospective study of testicular sperm extraction in young versus adult patients with nonmosaic 47,XXY Klinefelter syndrome. The Journal of clinical endocrinology and metabolism. 2015;100(3):961-7.[Crossref] [PubMed] 
  25. Franik S, Hoeijmakers Y, D'Hauwers K, Braat DD, Nelen WL, Smeets D, et al. Klinefelter syndrome and fertility: sperm preservation should not be offered to children with Klinefelter syndrome. Human reproduction (Oxford, England). 2016;31(9):1952-9.[Crossref] [PubMed] 
  26. Ando M, Yamaguchi K, Chiba K, Miyake H, Fujisawa M. Outcome of microdissection testicular sperm extraction in azoospermic patients with Klinefelter syndrome and other sex-chromosomal anomalies. Systems biology in reproductive medicine. 2013;59(4):210-3.[Crossref] [PubMed] 
  27. Haliloglu AH, Tangal S, Gulpinar O, Onal K, Pabuccu R. Should repeated TESE be performed following a failed TESE in men with Klinefelter Syndrome? Andrology. 2014;2(1):42-4.[Crossref] [PubMed] 
  28. Madgar I, Dor J, Weissenberg R, Raviv G, Menashe Y, Levron J. Prognostic value of the clinical and laboratory evaluation in patients with nonmosaic Klinefelter syndrome who are receiving assisted reproductive therapy. Fertility and sterility. 2002;77(6):1167-9.[Crossref] 
  29. Ozveri H, Kayabasoglu F, Demirel C, Donmez E. Outcomes of Micro-Dissection TESE in Patients with Non-Mosaic Klinefelter's Syndrome without Hormonal Treatment. International journal of fertility & sterility. 2015;8(4):421-8.
  30. Friedler S, Raziel A, Strassburger D, Schachter M, Bern O, Ron-El R. Outcome of ICSI using fresh and cryopreserved-thawed testicular spermatozoa in patients with non-mosaic Klinefelter's syndrome. Human reproduction (Oxford, England). 2001;16(12):2616-20.[Crossref] [PubMed] 
  31. Kahraman S, Findikli N, Berkil H, Bakircioglu E, Donmez E, Sertyel S, et al. Results of preimplantation genetic diagnosis in patients with Klinefelter's syndrome. Reproductive biomedicine online. 2003;7(3):346-52.[Crossref] 
  32. Miki T, Nagayoshi M, Takemoto Y, Yamaguchi T, Takeda S, Watanabe S, et al. Genetic risk of Klinefelter's syndrome in assisted reproductive technology. Reproductive medicine and biology. 2017;16(2):188-95.[Crossref] [PubMed] [PMC] 
  33. Madureira C, Cunha M, Sousa M, Neto AP, Pinho MJ, Viana P, et al. Treatment by testicular sperm extraction and intracytoplasmic sperm injection of 65 azoospermic patients with non-mosaic Klinefelter syndrome with birth of 17 healthy children. Andrology. 2014;2(4):623-31.[Crossref] [PubMed] 
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