Successful testicular sperm retrieval in adolescents with Klinefelter syndrome treated with at least 1 year of topical testosterone and aromatase inhibitor

Abstract

Objective: To evaluate surgical sperm retrieval rates in adolescents with Klinefelter syndrome and testosterone replacement therapy (TRT).

Design: Case series.

Setting: Academic medical center.

Patient(s): Ten patients with Klinefelter syndrome, aged 14-22 years, treated with testosterone replacement and aromatase inhibitor therapy for a period of 1-5 years before surgical sperm retrieval.

Intervention(s): Microsurgical testis sperm extraction with cryopreservation of harvested tissue.

Main outcome measure(s): Presence of spermatozoa within testis tissue.

Result(s): Successful sperm retrieval in 7/10 patients (70%).

Conclusion(s): Use of topical TRT did not appear to suppress spermatogenesis in adolescents with KS. It is uncertain whether sperm retrieval rates would be higher or lower without testosterone replacement in these young males. Sperm cryopreservation should be discussed in all KS adolescents who are either receiving or considering initiating TRT.

Keywords: Klinefelter syndrome; hormone replacement; testicular sperm extraction; testosterone.