Fertility Options in KS Can Safely Wait Until Adulthood, Study Finds

Background: Klinefelter syndrome (KS) is the most common genetic cause of azoospermia, characterized by progressive germ cell loss and testicular dysfunction, leading to controversy over whether sperm retrieval should occur shortly after puberty or can be delayed. Objective: To evaluate if age, specifically adolescence versus adulthood, correlated with surgical sperm retrieval success in nonmosaic KS. Design: Systematic review and meta-analysis. Methods: PubMed, Embase, and Medline were searched through January 15, 2025. Studies reporting outcomes of conventional testicular sperm extraction (cTESE) or microdissection testicular sperm extraction (mTESE) were included. Extracted variables included age, sperm retrieval rate (SRR), live birth rate (LBR), hormonal parameters, and testicular volume. Random-effects meta-analyses and meta-regression were performed. Results: This systematic review and meta-analysis was conducted according to Preferred Reporting Items for Systematic Review and more...