非嵌合型克氏综合征患者行睾丸显微取精术的临床结局分析

Clinical outcome analysis of testicular microsurgical sperm retrieval in patients with non-chimeric Klinefelter syndrome

目的分析非嵌合型克氏综合征(KS)患者行睾丸切开显微取精术(M-TESE)的临床结局。方法回顾性分析2018年1月至2023年12月于南昌市生殖医院行M-TESE的38例KS患者(染色体核型为47,XXY)的临床资料。所有患者均行M-TESE,根据是否成功获取精子分为获取组(n=17)与未获取组(n=21)。比较两组临床资料,分析新鲜精子和冷冻精子行卵泡浆内单精子注射术(ICSI)的临床结局。结果两组年龄、身高、体质量、体重指数(BMI)、睾丸体积及卵泡刺激素(FSH)、黄体生成素(LH)、睾酮(T)水平比较差异无统计学意义。新鲜精子和冷冻精子的受精率、卵裂率、优质胚胎率、囊胚率、妊娠率比较差异无统计学意义。结论KS患者相关参数无法预测睾丸显微取精获取率,新鲜精子和冷冻精子有同样的临床结局,可根据实际情况和需求选择同周期或非同周期行ICSI。

Objective To analyse the clinical outcomes of microdissection testicular sperm extraction(M-TESE)in non-chimeric Klinefelter syndrome(KS)patients.Methods The clinical data of 38 KS patients(karyotype 47,XXY)who received M-TESE in Nanchang Reproductive Hospital from January 2018 to December 2023 were retrospectively analyzed.All patients were treated with M-TESE,and they were divided into the acquired group(n=17)and the non-acquired group(n=21)based on successful sperm acquisition.The clinical data were compared between the two groups,and the clinical outcome of intracytoplasmic sperm injection(ICSI)using fresh spermatozoa and frozen spermatozoa were analyzed.Results There were no significant differences in age,height,body mass,body mass index(BMI),testicular volume,follicle stimulating hormone(FSH),luteinizing hormone(LH)and testosterone(T)levels between the two groups.There were no significant differences in the fertilization rate,cleavage rate,quality embryo rate,blastocyst rate and pregnancy rate between fresh testicular sperm and non-frozen testicular sperm.Conclusion The related parameters of patients with KS can not predict the testicular micro sperm extraction rate,fresh testicular sperm and frozen sperm have the same clinical outcome,ICSI for same-cycle or non-same-cycle rows can be selected according to actual situation and needs.