Klinefelter and varicocele

Androlog Mail

To the androlog community,

I have a 37 yo patient married to a 21 yo woman. Testicular volumes around
5 mL, normal consistency, grade III varicocele on left side and grade I on
right side. He is azoospermic on many semen analysis and his FSH = 23. He
has been submitted to 3 previous ICSI procedures with testicular sperm with
no pregnancy. Only after that, a Karyotype analysis revealed a 47,XXY
Klinefelter syndrome. He is upset with the lack of previous diagnosis and
came to my offfice for counseling. He wants to avoid at all costs another
testicular procedure.

The question is: Is there a role to perform a microsurgical varicocele
repair in this patient in order to try to only ejaculate few sperm for ICSI
and potentially avoid TESE or microdissection?

Jorge Hallak, M.D.; Ph.D.
Assistant Professor of Urology and Scientific Coordinator, Center for Human
Reproduction University of Sao Palo Medical School
Director, Section of Human Reproduction, Infertility and Sexual Function of
the Brazilian Cancer Society
Rua Iguatemi, 192 #12
01451-010 - S=E3o Paulo, SP - Brazil
tel/fax: +55-11-3168-5543
hallakj@androscience.com.br
Received on Fri Apr 14 06:51:45 2006