Fertility preservation in Klinefelter boys: an update after 6 years experience

Research output: Unpublished contribution to conferenceUnpublished abstract

Abstract

Introduction: In the UZ Brussel we started to offer cryopreservation of testicular tissue to Klinefelter boys in 2009. In an initial retrospective study performed in seven non-mosaic 47,XXY adolescents, aged 13–16 years no sperm cells were observed after masturbation or after penile vibrostimulation or electroejaculation. Subsequently, testicular sperm extraction (TESE) was performed with the aim of finding sperm cells and if not preserving the spermatogonia by testicular tissue cryopreservation. The presence of spermatogonia was reported in five patients, although only one patient presented spermatogonia in seminiferous tubules showing a normal architecture. We continued offering this option to Klinefelter boys and are presenting an update of the success of cryopreserving sperm cells and/or spermatogonia in this abstract.

Material and Methods: A retrospective study was conducted in 20 non-mosaic 47,XXY adolescents, aged 12–19 years, who were invited for an experimental testicular tissue banking programme during their follow-up at the Paediatric Endocrinology Department of the UZ Brussel between 2009 and 2015. Paraffin-embedded testicular tissue was sectioned and stained with periodic acid Schiff(PAS)/ haematoxylin staining, and immunostainings were performed for Mage-A4. The presence of spermatogenesis and/or spermatogonia was evaluated.

Results: Motile sperm cells were isolated after an enzyme treatment on testicular tissue in one boy and were cryopreserved for future fertility options. In all the other boys, no sperm cells were found. When no spermatogonia were found in the first paraffin-embedded tissue piece, an additional vial was thawed to perform immunostaining for MAGE-A4. Spermatogonia were observed in nine boys with an occurrence of 0.2 up to 34.5% tubules having positive cells. Remarkably, spermatogonia were not observed in the testicular biopsy from the boy in which motile sperm cells were found. Fibrotic areas were observed in all but one patient.
Discussion: The cryopreservation of sperm cells was achieved in 5.0% of the patients, while spermatogonia were found in 45.0% of patients. The fibrotic process was also already initiated in the testicular tissue from these adolescent boys. To improve the changes of preserving spermatogonia, testicular tissue should be cryopreserved at a younger age in Klinefelter boys.
Original languageEnglish
Publication statusPublished - 10 Mar 2016
Event2nd Klinefelter workshop 2016 - factoty hotel, munster, Germany
Duration: 10 Mar 201612 Mar 2016

Workshop

Workshop2nd Klinefelter workshop 2016
CountryGermany
Citymunster
Period10/03/1612/03/16

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