Department of Urology, Weill Cornell Medical College, New York, New York, USA.
Fertil Steril. 2012 Aug;98(2):274-83. doi: 10.1016/j.fertnstert.2012.06.001. Epub 2012 Jun 23.
To investigate the impact of early hormone replacement therapy (HT) on sperm retrieval rates in patients with Klinefelter syndrome (KS).
A systematic review of the relevant literature using the PubMed NLM database.
RESULT(S): There are no randomized controlled trials evaluating the impact of HT on sperm retrieval or reproductive outcomes in men with KS. On average, surgical sperm retrieval rates in men with KS are around 51%, with a range of 28%-69%. Young patient age is the most consistent positive predictor of sperm retrieval. Lower retrieval rates have been reported in a small subset of KS adults who previously received exogenous T, although the nature, duration, and reason for such therapy in these patient subsets are unknown.
CONCLUSION(S): Early HT is recommended in patients with KS, but its effect on fertility potential has not been definitively studied. Larger studies are needed to better answer this question. Cryopreservation of sperm-containing semen or testicular tissue from a significant proportion of affected adolescents is possible, even when containing very low numbers of spermatozoa, and should be considered to maximize future fertility potential.
探讨早期激素替代疗法（HT）对克氏综合征（KS）患者精子获取率的影响。
使用 PubMed NLM 数据库进行相关文献的系统回顾。
目前尚无评估 HT 对 KS 男性精子获取或生殖结局影响的随机对照试验。KS 男性的平均手术精子获取率约为 51%，范围为 28%-69%。年轻患者年龄是精子获取的最一致的阳性预测因素。尽管这些患者亚组中 HT 的性质、持续时间和原因尚不清楚，但有报道称，一小部分先前接受过外源性 T 的 KS 成年男性的获取率较低。
建议 KS 患者早期进行 HT，但 HT 对生育潜能的影响尚未得到明确研究。需要更大的研究来更好地回答这个问题。即使精子数量非常低，也可以对大多数受影响的青少年的含精子精液或睾丸组织进行冷冻保存，以最大限度地提高未来的生育潜能。
