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Hormonal Profile in Klinefelter Patients Does Predict TESE Results
Andrew C Kramer, Todd J. Lehrfeld
University of Maryland, Baltimore, MD

Introduction: Klinefelter syndrome (KS) is the most common chromosomal abnormality resulting in infertility. With TESE, a number of KS patients do have sperm, and some have fathered children with ICSI. There exist few comparisons between the sub-populations of patients with and without successful TESE. It remains elusive whether FSH and LH are predictive of TESE outcome.
Methods: 20 patients who underwent TESE were retrospectively reviewed, and LH, FSH (from one lab),and TESE results recorded. 13 patients had no sperm on TESE, while 7 did.
Results: There is a significant difference in the FSH and LH between men with sperm on TESE (T+) and without sperm on TESE (T-). The mean range of FSH for T+ was 226.62 +/- 132.3 and for T- was 329.65 +/-111.1 (p=.039). The mean range for LH in T+ was 148.76 +/-63.3 and 212.52+/-85.0 for T- (p=.05).
Conclusions: Men with KS do not demonstrate a homogenous group with unpredictable behavior on TESE. This data demonstrates a difference between men with and without sperm on TESE. Those without sperm tend to have a more pronounced elevation of LH and FSH, perhaps due to more seminiferous tubule fibrosis than their counterparts with sperm. As more patients are studied it may be possible to look at the FSH or LH as a tool to predict the likelihood of finding sperm in the testis. More patients with KS present to the clinician now because of health screenings in the community and schools, and their fertility potential will become increasingly important.

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