NEW YORK (Reuters Health) - Testicular sperm extraction (TESE) along with intracytoplasmic sperm injection (ICSI) is successful in restoring fertility in most patients with Klinefelter syndrome and azoospermia, according to researchers at New York-Weill Cornell Medical Center and the Population Council, New York.

As senior investigator Dr. Peter N. Schlegel told Reuters Health, "Klinefelter syndrome is the most common sex chromosome abnormality, affecting 1 in 500 men. Until recently, nearly all men with this condition were considered sterile. Using a novel microsurgical technique, the fertility group at Cornell has been able to successfully find sperm in the testes of over 70% of men with condition."

In the sperm extraction procedure, "the testis was widely opened in an equatorial plane and microdissection carried out." Enlarged seminiferous tubules are removed until sperm is identified or all areas of both testes have been examined.

In the November issue of the Journal of Clinical Endocrinology and Metabolism, Dr. Schlegel and colleagues retrospectively review the outcome in 42 patients with nonmosaic Klinefelter syndrome who underwent 54 TESE procedures during an 8-year period.

Sperm was retrieved in 72% of attempts, and 29 of the men (69%) had sufficient sperm found to perform ICSI. This, say the investigators, is a "slightly higher" success rate than reported by other groups.

In all, 39 in vitro fertilization cycles yielded embryos for transfer. This led to 18 clinical pregnancies resulting in 21 live births.

Thus concluded Dr. Schlegel, the approach allowed "pregnancy in approximately half of the treatment attempts with sperm found."

This, he added, "is the largest successful series reported, from the group that first described the possibility of successful treatment." Moreover, "all children born were healthy with normal chromosomes."

J Clin Endocrinol Metab 2005;90:6263-6267

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