Sperm retrieval in adolescent males with Klinefelter syndrome: medical and ethical issues

Many men with conditions linked to azoospermia were formerly considered infertile. However, over the last two decades advances in assisted reproductive technology (ART) have been devised and have permitted these men to become biological fathers. Foremost among these have been testicular sperm extraction (TESE) and a “microdissection” advance in which individual spermatic tubules are punctured and sperm extracted (microTESE). In the former multiple biopsies of the subject’s testes are taken and sperm retrieved as available (1). The micro technique originally noted by Schlegel and colleagues considers individual tubules for micropuncture using optical magnification (2,3). Sperm retrieval rates (SRR) are somewhat higher when performing the latter technique on men with non-obstructive azoospermia or men with Klinefelter syndrome (KS) or one of its variants (2,4,5).