Evaluation of the predictors of successful sperm retrieval of micro-TESE in cases with mosaic Klinefelter versus cases with non-mosaic Klinefelter: a prospective case series study

Abstract Background We evaluated the predictors of eventful microsurgical testicular sperm extraction (micro-TESE) from infertile men with Klinefelter syndrome (KS). Results The mean age of the patients was 32.4 ± 6.3 years. The mean serum levels of follicle stimulating hormone (FSH), luteinizing ho...

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Main Authors: Amr Elahwany, Fatma A. Elrefaey, Hisham Alahwany, Hesham Torad, Sameh Fayek GamalEl Din, Rashad Mohammed Saeed Dawood, Mohamed Wael Ragab, Ahmed Fawzy Megawer
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Language:English
Published: BMC 2025-05-01
Series:Basic and Clinical Andrology
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Online Access:https://doi.org/10.1186/s12610-025-00265-2
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author Amr Elahwany
Fatma A. Elrefaey
Hisham Alahwany
Hesham Torad
Sameh Fayek GamalEl Din
Rashad Mohammed Saeed Dawood
Mohamed Wael Ragab
Ahmed Fawzy Megawer
author_facet Amr Elahwany
Fatma A. Elrefaey
Hisham Alahwany
Hesham Torad
Sameh Fayek GamalEl Din
Rashad Mohammed Saeed Dawood
Mohamed Wael Ragab
Ahmed Fawzy Megawer
author_sort Amr Elahwany
collection DOAJ
description Abstract Background We evaluated the predictors of eventful microsurgical testicular sperm extraction (micro-TESE) from infertile men with Klinefelter syndrome (KS). Results The mean age of the patients was 32.4 ± 6.3 years. The mean serum levels of follicle stimulating hormone (FSH), luteinizing hormone (LH), total testosterone (TT), estradiol (E2) and prolactin were 34.38 ± 14.66, 18.92 ± 6.54, 3.18 ± 2.08, 28.2 ± 10, 11.56 ± 5.09, respectively. The mean right (Rt) testicular and left (Lt) testicular volumes were 2.17 ± 0.83 ml, 2.2 ± 0.89 ml, respectively. Mosaic KS patients showed highly significant TT compared to non-mosaic KS patients. Twenty-six patients out of 50 patients (52%) showed mature sperm in wet preparation, whereas the sperm retrieval rate (SRR) of the patients with mosaic and non-mosaic KS was (57.1) % and (32.1) %, respectively. SR was significantly associated with testicular volume > 2 ml, total testicular volume > 5 ml and LH < 21.29 IU/L (p 0.007, 0.005, 0.044, respectively). FISH testing results showed that higher 46xy and lower 47xxy were significantly associated with successful sperm retrieval (p 0.014, 0.015, respectively). Rt and Lt testicular volumes, total testicular volume, LH and FISH could significantly predict successful SR. No statistically significant correlations were found between micro-TESE and age, serum FSH, serum TT, E2, prolactin. Further, receiver operation characteristic (ROC) curve showed Rt and Lt testicular volumes and total testicular volume and LH level and 46xy could significantly predict successful SR with p 0.007, 0.007, 0.005 and 0.044 and 0.015, respectively. Moreover, the cutoff point and sensitivity and specificity and positive and negative predictive values for Rt and Lt testicular volumes were as follows 2 ml, 73.1%, 61.4%, 52.78, 79.41, 2 ml, 76.9%, 57.8%, 51.28 and 80.65, respectively. While these values for total testicular volume were as follows 5.255 ml, 61.5, 75, 59.26 and 76.74, respectively. Furthermore, these values for LH and 46xy were as follows 17 IU/l, 73.1%, 50%, 46.34, 75.86, 16.35, 84.6, 50, 50 and 84.6, respectively. Conclusions Patients with mosaic KS had higher rates of SRR compared to non-mosaic KS.
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spelling doaj-art-7cfa332b53a242e58187ed0863a70b1a2025-08-20T03:48:18ZengBMCBasic and Clinical Andrology2051-41902025-05-0135111010.1186/s12610-025-00265-2Evaluation of the predictors of successful sperm retrieval of micro-TESE in cases with mosaic Klinefelter versus cases with non-mosaic Klinefelter: a prospective case series studyAmr Elahwany0Fatma A. Elrefaey1Hisham Alahwany2Hesham Torad3Sameh Fayek GamalEl Din4Rashad Mohammed Saeed Dawood5Mohamed Wael Ragab6Ahmed Fawzy Megawer7Department of Andrology and STDs Kasr Al-Ainy, Faculty of Medicine Cairo UniversityDepartment of Clinical Pathology, National Cancer InstituteNile IVF CenterDepartment of Urology, Kasr Alainy Faculty of Medicine, Cairo UniversityDepartment of Andrology and STDs Kasr Al-Ainy, Faculty of Medicine Cairo UniversityMinistry of HealthDepartment of Andrology and STDs Kasr Al-Ainy, Faculty of Medicine Cairo UniversityDepartment of Andrology and STDs Kasr Al-Ainy, Faculty of Medicine Cairo UniversityAbstract Background We evaluated the predictors of eventful microsurgical testicular sperm extraction (micro-TESE) from infertile men with Klinefelter syndrome (KS). Results The mean age of the patients was 32.4 ± 6.3 years. The mean serum levels of follicle stimulating hormone (FSH), luteinizing hormone (LH), total testosterone (TT), estradiol (E2) and prolactin were 34.38 ± 14.66, 18.92 ± 6.54, 3.18 ± 2.08, 28.2 ± 10, 11.56 ± 5.09, respectively. The mean right (Rt) testicular and left (Lt) testicular volumes were 2.17 ± 0.83 ml, 2.2 ± 0.89 ml, respectively. Mosaic KS patients showed highly significant TT compared to non-mosaic KS patients. Twenty-six patients out of 50 patients (52%) showed mature sperm in wet preparation, whereas the sperm retrieval rate (SRR) of the patients with mosaic and non-mosaic KS was (57.1) % and (32.1) %, respectively. SR was significantly associated with testicular volume > 2 ml, total testicular volume > 5 ml and LH < 21.29 IU/L (p 0.007, 0.005, 0.044, respectively). FISH testing results showed that higher 46xy and lower 47xxy were significantly associated with successful sperm retrieval (p 0.014, 0.015, respectively). Rt and Lt testicular volumes, total testicular volume, LH and FISH could significantly predict successful SR. No statistically significant correlations were found between micro-TESE and age, serum FSH, serum TT, E2, prolactin. Further, receiver operation characteristic (ROC) curve showed Rt and Lt testicular volumes and total testicular volume and LH level and 46xy could significantly predict successful SR with p 0.007, 0.007, 0.005 and 0.044 and 0.015, respectively. Moreover, the cutoff point and sensitivity and specificity and positive and negative predictive values for Rt and Lt testicular volumes were as follows 2 ml, 73.1%, 61.4%, 52.78, 79.41, 2 ml, 76.9%, 57.8%, 51.28 and 80.65, respectively. While these values for total testicular volume were as follows 5.255 ml, 61.5, 75, 59.26 and 76.74, respectively. Furthermore, these values for LH and 46xy were as follows 17 IU/l, 73.1%, 50%, 46.34, 75.86, 16.35, 84.6, 50, 50 and 84.6, respectively. Conclusions Patients with mosaic KS had higher rates of SRR compared to non-mosaic KS.https://doi.org/10.1186/s12610-025-00265-2Mosaic Kleinfelter syndromeAzoospermiaMicro-TESE
spellingShingle Amr Elahwany
Fatma A. Elrefaey
Hisham Alahwany
Hesham Torad
Sameh Fayek GamalEl Din
Rashad Mohammed Saeed Dawood
Mohamed Wael Ragab
Ahmed Fawzy Megawer
Evaluation of the predictors of successful sperm retrieval of micro-TESE in cases with mosaic Klinefelter versus cases with non-mosaic Klinefelter: a prospective case series study
Basic and Clinical Andrology
Mosaic Kleinfelter syndrome
Azoospermia
Micro-TESE
title Evaluation of the predictors of successful sperm retrieval of micro-TESE in cases with mosaic Klinefelter versus cases with non-mosaic Klinefelter: a prospective case series study
title_full Evaluation of the predictors of successful sperm retrieval of micro-TESE in cases with mosaic Klinefelter versus cases with non-mosaic Klinefelter: a prospective case series study
title_fullStr Evaluation of the predictors of successful sperm retrieval of micro-TESE in cases with mosaic Klinefelter versus cases with non-mosaic Klinefelter: a prospective case series study
title_full_unstemmed Evaluation of the predictors of successful sperm retrieval of micro-TESE in cases with mosaic Klinefelter versus cases with non-mosaic Klinefelter: a prospective case series study
title_short Evaluation of the predictors of successful sperm retrieval of micro-TESE in cases with mosaic Klinefelter versus cases with non-mosaic Klinefelter: a prospective case series study
title_sort evaluation of the predictors of successful sperm retrieval of micro tese in cases with mosaic klinefelter versus cases with non mosaic klinefelter a prospective case series study
topic Mosaic Kleinfelter syndrome
Azoospermia
Micro-TESE
url https://doi.org/10.1186/s12610-025-00265-2
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