اختلالات هورموني و هيستوپاتولوژي بيضه، در بيماران آزواسپرمي مبتلا به سندرم كلاين فلتر

Hormonal abnormalities and histopathology of testis in azoospermic patients with Klinefelterʹs syndrome

Background: Azoospermia is prevalent in approximately 15-20% of men. Chromosomal abnormality is an important cause of azoospermia and Klinefelter ʹs Syndrome (KS) is one of the most common sex-chromosome abnormalities. In spite ofnumerous studies on KS, the relationship between honnonaI abnormalities and histopathology of the te stes is not quite clear. The aim of present study was to compare hormonal abn ormalities and testical pathology in patients with KS and azoosperrnic patients with normal karyotypes (NK) . Methods: From Oct ober 2004 to November 2006, a total number of 310 patients with infertility due to azo ospermia were referred to Avicenna Infertility Clinic in Tehran, Iran and were enrolled int o the stud y. The patients medical history were taken , physical examination wer e carr ied out and semen, hormonal (FSH, LH, testoster one and prolactin), chromosomal analyses and testicular biopsies were done in all patients. The patients were divided into two groups; KS and patients with normal karyotypes depending on kar yotyping results. Th e data were analyzed by SPSS software, version 11.5, and p-values smaller than 0.05 were considered significant. Variations between the two groups were evaluated by unpaired t-tests. Proportions were analyzed usin g the chisquare test. Results: Among the 310 referred azoospermic patients to the center, 31 patients (10%) were diagnosed as Klinefelterʹs syndrome (3 with mosaic and 28 with non-mosaic KS) . Mean FSH and LH in KS patients were 48.9±29.1 l Ull and 24.5±25.4 l Ull respectively. However, mean FSH and LH levels in azoospermic patients with normal karyotypes were 24±I9.1 l UI! and 9±7.2 l Ull respectively. Th ere were no significant differences betw een testoster one and prolactin level s in both groups. Histopathological studies showed remarkable variation s regarding spermatogenesis in KS patients - mostly showed Sertol i cell only syndrome (54.8%) and no sperms were found in testicular biopsies . However , 15% of NK patients had normal spermatogenes is upon testicular biopsy. Conclusion: As Klinefelter ʹ s syndrome shows a great variety of different phenotypes, diagnosis is often delayed or patients remain undiagnosed . Hormonal evalu ations of FSH and LH could help in the early diagnosis of the syndrome to prevent sequela of the syndrome.