Age and partial AZFc deletion do not predict sperm retrieval in non-mosaic Klinefelter patients
Microsurgical testicular sperm retrieval (mTESE) provided the best way for sperm retrieval in nonmosaic 47, XXY men with azoospermia. Age and testosterone levels after treatment are prognostic factors for successful sperm retrieval. Whether Y chromosome deletion determine the sperm retrieval rate in non-mosaic Klinefelter patient has not been addressed. The objective of this study was to evaluate the prognostic factors for sperm retrieval and determine if Y chromosome deletion could lead to deleterious effect.
The medical records of azoospermic patients were retrospectively collected from Sep 2009 to July 2017, and enrolled 53 non-mosaic 47,XXY patients receiving mTESE. The predictive values of patients age, serum follicle-stimulating hormone (FSH), luteinizing hormone (LH), testosterone, prolactin, estradiol and Y chromosome deletion testing were assessed for successful sperm recovery. The Student’s t test was used to compare hormone profiles and Fisher’s exact test was used for comparison of Y chromosome deletion among the sperm retrieval successful and failure groups.
Testicular sperm recovery was successful in 20 (37.7%) of 53 men. The mean levels of age (35.9 vs. 36.8 years), FSH (30.8 vs 37.5 IU/L), LH (17.5 vs 22.5 IU/L), testosterone (2.1 vs. 2.2 ng/ml), prolactin (9.1 vs. 8.8 ng/ml) and estradiol (19.4 vs. 22.3 pg/ml) did not show any significant difference comparing with patients with and without successful sperm retrieval. Sperm retrieval rate was comparable for patient below (36.4%) or above (37.5%) 35 years old. The partial azoospermic factor c (AZFc) deletion was noticed in 4 (20%) of 20 patients with successful sperm retrieval, including two sY1191 and two sY1291 deletion cases, whereas 4 (12.1%) of 33 patients was noted to have AZFc partial deletion (one sY1191, one sY1206 and two sY1291), but the difference was not statistically significant (p= 0.46)
According to present results, age and AZFc partial deletion status should not be the reason to discourage azoospermic non-mosaic 47,XXY men for receiving mTESE.