What should be the minimum frequency of micro testicular sperm extraction (m-TESE) in patients with Klinefelter syndrome?

Abstract

Aim: To investigate whether a second or even a third surgery is required for sperm retrieval in non-mosaic Klinefelter syndromepatients who underwent a successful/failed micro-testicular sperm extraction (m-TESE).Material and Methods: The patients underwent physical examination, genetic analyses, pathological screening between 2008 and2018. In the patients, sperm retrieval rates, pregnancy after intracytoplasmic sperm injection (ICSI) and baby take-home rates wereexamined.Results: M-TESE was repeated for the second time in thirty-five patients in total, with twenty of that underwent their first m-TESEwith a negative result and fifteen with a positive result. In =6/20 patients (30%) who had a negative result with the first m-TESEand in n=9/15 patients (60%) who had a positive result with the first m-TESE, sperm was detected the second time. Pregnancy wasachieved in n=2/6 patients (33%) who were negative the first time and positive the second time. Baby take-home was achieved inone patient (16.6%).Conclusion: In addition to patients from whom sperm could be retrieved previously, sperm could be detected especially in the secondand even third redo m-TESE in patients from whom sperm could not be retrieved. Pregnancy occurred and baby take-home wasachieved. Despite the presence of a very limited testicular tissue, it is recommended for this procedure to be performed by expertpractitioners upon discussing very openly the complications and achievements, to decide accordingly and repeat m-TESE in thesepatients where possible.