Testicular biopsy and cryopreservation for fertility preservation of pre-pubertal boys with Klinefelter syndrome: a pro con debate
Although fertility preservation techniques in boys and adolescents with Klinefelter syndrome are an emerging field, many technical and ethical issues remain, so these techniques should continue to be viewed as experimental.
Inge Gies, M.D., Robert Oates, M.D., Jean de Schepper, M.D., Ph.D., Herman Tournaye, M.D., Ph.D.
Volume 105, Issue 2, Pages 249-255
In about one-half of adult Klinefelter syndrome (KS) patients, spermatozoa can be retrieved by means of testicular biopsy (TESE). Given the expected increase in the number of diagnosed KS patients owing to the use of noninvasive prenatal testing, the probable questions of young KS patients and their parents regarding future fertility, and the fact that widespread apoptosis of spermatogonia occurs at onset of puberty, an attempt to increase the retrieval rates at TESE above those found in adult KS men by undertaking preservation techniques peripubertally has been initiated. To date, however, only a limited number of KS adolescents have been examined, demonstrating no increases in the chances of finding sperm. Furthermore, spermatogonial stem cell and testicular tissue freezing techniques, as well as in vitro maturation strategies, require further validation. Given these controversies, banking testicular tissue from prepubertal KS boys should be performed only in a research framework.
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