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The Evidence for Fertility Preservation in Pediatric Klinefelter Syndrome

Klinefelter syndrome (KS) is a common cause of non-obstructive azoospermia (NOA). Advances in fertility preservation (FP) techniques, such as the use of microdissection testicular sperm extraction (micro-TESE), have improved sperm retrieval rates (SRR) up to 40–50% in this population. Age has been s...

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Autores principales: Pook, Celina J., Cocca, Alessandra, Grandone, Anna, Al-Hussini, Mohamed, Lam, Wayne
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9580826/
https://www.ncbi.nlm.nih.gov/pubmed/36304035
http://dx.doi.org/10.3389/frph.2021.629179
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author Pook, Celina J.
Cocca, Alessandra
Grandone, Anna
Al-Hussini, Mohamed
Lam, Wayne
author_facet Pook, Celina J.
Cocca, Alessandra
Grandone, Anna
Al-Hussini, Mohamed
Lam, Wayne
author_sort Pook, Celina J.
collection PubMed
description Klinefelter syndrome (KS) is a common cause of non-obstructive azoospermia (NOA). Advances in fertility preservation (FP) techniques, such as the use of microdissection testicular sperm extraction (micro-TESE), have improved sperm retrieval rates (SRR) up to 40–50% in this population. Age has been suggested to have an impact on FP, postulating that sperm production may deteriorate over time due to germ cell loss. As such, sperm retrieval for patients with KS at a younger age has been proposed to further improve SRR; however, whether such practice pragmatically improves SRR is yet to be determined, and controversy remains with concerns over trauma caused by FP procedures on further impairment of testicular function. There has also been a debate on the ethics of performing FP procedures in the pediatric population. Optimizing FP for patients with KS invariably requires a holistic multidisciplinary approach. This review aimed to evaluate the latest evidence in performing FP in pediatric patients with KS, and discuss the controversy surrounding such practice. Hormonal changes in patients with KS during childhood and the use of hormonal manipulation to optimize SSR in this population have also been reviewed.
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spelling pubmed-95808262022-10-26 The Evidence for Fertility Preservation in Pediatric Klinefelter Syndrome Pook, Celina J. Cocca, Alessandra Grandone, Anna Al-Hussini, Mohamed Lam, Wayne Front Reprod Health Reproductive Health Klinefelter syndrome (KS) is a common cause of non-obstructive azoospermia (NOA). Advances in fertility preservation (FP) techniques, such as the use of microdissection testicular sperm extraction (micro-TESE), have improved sperm retrieval rates (SRR) up to 40–50% in this population. Age has been suggested to have an impact on FP, postulating that sperm production may deteriorate over time due to germ cell loss. As such, sperm retrieval for patients with KS at a younger age has been proposed to further improve SRR; however, whether such practice pragmatically improves SRR is yet to be determined, and controversy remains with concerns over trauma caused by FP procedures on further impairment of testicular function. There has also been a debate on the ethics of performing FP procedures in the pediatric population. Optimizing FP for patients with KS invariably requires a holistic multidisciplinary approach. This review aimed to evaluate the latest evidence in performing FP in pediatric patients with KS, and discuss the controversy surrounding such practice. Hormonal changes in patients with KS during childhood and the use of hormonal manipulation to optimize SSR in this population have also been reviewed. Frontiers Media S.A. 2021-08-03 /pmc/articles/PMC9580826/ /pubmed/36304035 http://dx.doi.org/10.3389/frph.2021.629179 Text en Copyright © 2021 Pook, Cocca, Grandone, Al-Hussini and Lam. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Reproductive Health
Pook, Celina J.
Cocca, Alessandra
Grandone, Anna
Al-Hussini, Mohamed
Lam, Wayne
The Evidence for Fertility Preservation in Pediatric Klinefelter Syndrome
title The Evidence for Fertility Preservation in Pediatric Klinefelter Syndrome
title_full The Evidence for Fertility Preservation in Pediatric Klinefelter Syndrome
title_fullStr The Evidence for Fertility Preservation in Pediatric Klinefelter Syndrome
title_full_unstemmed The Evidence for Fertility Preservation in Pediatric Klinefelter Syndrome
title_short The Evidence for Fertility Preservation in Pediatric Klinefelter Syndrome
title_sort evidence for fertility preservation in pediatric klinefelter syndrome
topic Reproductive Health
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9580826/
https://www.ncbi.nlm.nih.gov/pubmed/36304035
http://dx.doi.org/10.3389/frph.2021.629179
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