Predictive value of serum AMH for micro-TESE outcomes in patients with non-mosaic Klinefelter syndrome
10.3760/cma.j.cn101441-20240916-00344
- VernacularTitle:血清AMH对非嵌合型克氏综合征患者睾丸显微取精结局的预测价值
- Author:
Hang XIN
1
;
Jinhao LIU
1
;
Wenbin NIU
1
;
Shanjun DAI
1
;
Yu LIU
1
;
Yudong GUAN
1
;
Ning XU
1
;
Yihong GUO
1
Author Information
1. 郑州大学第一附属医院生殖医学中心，郑州 450000
- Publication Type:Journal Article
- Keywords:
Anti-Müllerian hormone;
Azoospermia;
Klinefelter syndrome;
Testosterone;
Microscopic testicular sperm extraction
- From:
Chinese Journal of Reproduction and Contraception
2025;45(4):372-379
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the predictive value of anti-Müllerian hormone (AMH) on the outcome of microscopic testicular sperm extraction (micro-TESE) in patients with non-mosaic Klinefelter syndrome (KS) of the clinical data and to identify effective predictors for successful micro-TESE.Methods:A retrospective case-control study was conducted on the clinical data of 118 non-mosaic KS patients treated at the Center for Reproductive Medicine of the First Affiliated Hospital of Zhengzhou University between May 2018 and September 2023. Patients were divided into two groups based on whether sperm were successfully retrieved via micro-TESE: the sperm retrieved group ( n=45) and the no sperm retrieved group ( n=73). Differences between the two groups were compared, and multivariate logistic regression analysis was used to identify factors influencing sperm retrieval. Changes in testicular volume and sex hormone levels before and after surgery were also assessed. Results:The sperm retrieval rate was 38.1% (45/118). Patients in the sperm retrieved group were significantly younger [(26.93±3.80) years] than those in the no sperm retrieved group [(28.27±3.92) years, P=0.029], and the AMH level was significantly higher [0.44 (0.18, 1.13) μg/L] than that in the no sperm retrieved group [0.10 (0.03, 0.22) μg/L, P<0.001]. AMH was identified as an independent predictor of micro-TESE outcome in non-mosaic KS patients ( OR=7.867, 95% CI: 2.727-27.242, P=0.001). The area under the receiver operating characteristic curve was 0.802 (95% CI: 0.722-0.883), and the optimal reference threshold for AMH was ≥0.265 μg/L. Postoperatively, testosterone levels decreased significantly by a median of 0.27 μg/L ( P=0.019), while luteinizing hormone levels increased by a median of 2.08 U/L ( P=0.049), with a more significant decline in testosterone levels observed in the no sperm retrieved group by a median of 0.29 μg/L ( P=0.022). Conclusion:AMH can predict successful micro-TESE in non-mosaic KS patients, with higher AMH levels indicating a higher likelihood of success.
