Aliakbari Fereshteh, Taghizabet Neda, Rezaei-Tazangi Fatemeh, Kalantari Hamid, Vosough Dizaj Ahmad, Mohammadi Maryam, Sajadi Hesamoddin, Sadighi Gilani Mohammad Ali
Men's Health and Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Department of Anatomy, School of Medicine, Fasa University of Medical Sciences, Fasa, Iran.
Int J Fertil Steril. 2023 Aug 7;17(4):276-280. doi: 10.22074/ijfs.2023.562534.1371.
This study aimed to evaluate the predicting factors affecting sperm retrieval. We prospectively assessed the relationship between sonographic and microdissection testicular sperm extraction (mTESE) findings in Klinefelter syndrome (KS).
In this prospective study, 44 azoospermic men with 47, XXY karyotypes participated in this study. In order to evaluate the amount of blood supply in different parts of testicular tissue, a doppler ultra-sonographic was performed. Also, for the detection of sperm in this group mTESE technique was performed.
The age average of positive mTESE and negative mTESE groups was 29.4 and 33.6 years, respectively. By comparing the testicle volume (based on the data obtained from the clinical examinations conducted by the urologist) it was determined that there is no significant difference between mTESE positive and negative groups. Folliclestimulating hormone (FSH) levels in men with negative mTESE (P=0.03) and testosterone levels in men with positive mTESE significantly increased (P=0.017). The overall rate of testis vascularity was significantly higher in the positive mTESE group than in the negative mTESE group. The clinical pregnancy rate in positive mTESE men was 9% per cycle, 16.6% per embryos were transferred (ET), and 12.5% per cycle.
Totally, our observation indicated that there is not a significant relationship between sonographic and mTESE results in KS patients. However, more investigations with bigger sample Size can be useful to validate our results.
本研究旨在评估影响精子获取的预测因素。我们前瞻性地评估了克氏综合征（KS）患者的超声检查结果与显微切割睾丸精子提取术（mTESE）结果之间的关系。
在这项前瞻性研究中，44名核型为47, XXY的无精子症男性参与了本研究。为了评估睾丸组织不同部位的血供情况，进行了多普勒超声检查。此外，对该组患者采用mTESE技术检测精子。
mTESE阳性组和阴性组的平均年龄分别为29.4岁和33.6岁。通过比较睾丸体积（基于泌尿科医生临床检查获得的数据），发现mTESE阳性组和阴性组之间无显著差异。mTESE阴性男性的促卵泡激素（FSH）水平（P = 0.03）以及mTESE阳性男性的睾酮水平显著升高（P = 0.017）。mTESE阳性组的睾丸血管总体发生率显著高于mTESE阴性组。mTESE阳性男性的临床妊娠率为每周期9%，每次胚胎移植（ET）为16.6%，每周期为12.5%。
总体而言，我们的观察表明KS患者的超声检查结果与mTESE结果之间无显著关系。然而，进行更大样本量的更多研究可能有助于验证我们的结果。
