Service de Biochimie et Biologie Moléculaire, Centre de Biologie et de Pathologie Est, Hospices Civils de Lyon, Bron, France; Service de Médecine de la Reproduction, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon, Bron, France; Université Claude-Bernard Lyon 1, Lyon, France; Inserm U1208, 18, avenue Doyen-Lépine, 69675 Bron cedex, France.
Service de Médecine de la Reproduction, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon, Bron, France; Université Claude-Bernard Lyon 1, Lyon, France; Inserm U1208, 18, avenue Doyen-Lépine, 69675 Bron cedex, France.
Ann Endocrinol (Paris). 2022 Jun;83(3):172-176. doi: 10.1016/j.ando.2022.05.002. Epub 2022 May 5.
Patients with a Klinefelter syndrome (KS), defined by a 47 XXY karyotype, were long considered infertile. Testicular sperm extraction (TESE) now allows them to access fatherhood. We will present the data of studies since first experiment of TESE. Several factors influencing TESE outcome were proposed in these different studies. Among them, clinical and hormonal parameters have reported by few studies, age has been one of the most discussed prognostic factor of positive sperm retrieval rate. Data seems to show that TESE carried out before an age greater than 30 has a poorer prognosis for positive sperm retrieval. In few studies performed in younger patient, before 20 years, SRR was closed to result for 20 to 30 year old patients. Offering a TESE before 16 years old does not improve positive sperm extraction rate. In fact, the few studies carried out before the age of 16 were of poorer prognosis, most often linked to insufficient maturation of the residual gametes. In addition, androgen therapy, frequently prescribed in case of Klinefelter syndrome, did not seem to show any effect on sperm retrieval but only few studies were interested in the possible impact of this treatment. In conclusion, further studies are necessary to determine the interest of new markers to predict the chance of sperm retrieval, taking into account age, hormonal therapy.
克氏综合征（KS）患者的核型定义为 47 XXY，长期以来被认为是不育的。睾丸精子提取（TESE）现在使他们能够实现父亲身份。我们将介绍自首次 TESE 实验以来的研究数据。这些不同的研究提出了影响 TESE 结果的几个因素。其中，一些研究报道了临床和激素参数，但年龄是最受讨论的预测有丝分裂精子获取率阳性的因素之一。数据似乎表明，在年龄大于 30 岁时进行 TESE，其有丝分裂精子获取的预后较差。在一些对年轻患者进行的研究中，在 20 岁之前，SRR 接近 20 至 30 岁患者的结果。在 16 岁之前进行 TESE 并不能提高有丝分裂精子提取率。事实上，在 16 岁之前进行的少数研究预后较差，通常与残留配子的成熟不足有关。此外，雄激素治疗在克氏综合征的情况下经常被处方，但似乎对精子获取没有任何影响，但只有少数研究对这种治疗的可能影响感兴趣。总之，需要进一步的研究来确定新的标记物以预测精子获取机会的意义，同时考虑年龄、激素治疗。
