Mr. Tuan (30 years old) from Khanh Hoa came to Ho Chi Minh City for a check-up at a hospital after two years of marriage without children. He was shocked when, although he was physically healthy, he was diagnosed with no sperm in his semen, infertile.
Mr. Tuan was tested for genetics and diagnosed with Klinefelter syndrome. The doctor said the prognosis was poor and advised him to request sperm for in vitro fertilization (IVF) or adopt a child.
Doctor Ngo Dinh Trieu Vy - Reproductive Support Center, Tam Anh General Hospital, Ho Chi Minh City - said that normal men have 23 pairs of chromosomes, of which the sex chromosome pair is XY, while people with Klinefelter syndrome have two or more X chromosomes (XXY, XXXY...).
This sex chromosome aneuploidy can be due to genetics or random mutations during cell division, causing hypogonadism, testicular fibrosis, reduced sperm production, and infertility.
In cases of this syndrome, the ability to produce sperm may still be present in the early stages after puberty, but the condition becomes more severe over time.
According to world medical literature, usually after the age of 30, the rate of finding sperm in this group of patients is very low, only about 30%, after the age of 35, almost no sperm is found.
"Mr. Tuan refused to ask for sperm, micro-TESE surgery to find sperm is the only solution to help the patient have a chance to have children of the same bloodline" - Dr. Vy said.
During the 90-minute microsurgery, doctors searched both testicles in turn, selected more than 30 seminiferous tubule samples, and found one sample with enough sperm for an IVF cycle.
To optimize the chances of success, the wife had her eggs aspirated on the same day, at the same time as Mr. Tuan's microsurgery.
Early last October, Mr. Tuan's wife's uterine lining was prepared to meet the conditions. Dr. Vy selected a good quality embryo with the highest probability of pregnancy, transferred it into the uterus and helped her conceive.
The pregnancy is now 12 weeks and developing healthily. They have a good quality embryo frozen to give them the chance to have more children in the future.
According to Dr. Vy, recently, IVF doctors at Tam Anh HCMC have received and successfully treated many men with chromosomal abnormalities and gene mutations, accounting for about 15% of the total number of infertile men.
Common conditions are AZF deletion, Klinefelter syndrome, Jacobs syndrome... The cause can be genetic or mutations during cell division.
Depending on the case of male deletion of AZF, Klinefelter, Jacobs… there are different descriptions in medical literature. However, in reality in Vietnam, some men do not have typical symptoms of the disease. Their physical condition is completely normal, only discovering abnormalities after many years of marriage without children.
Many men discover the disease at a late stage, increasing difficulty and reducing the rate of finding sperm.
Therefore, couples who have not had children after one year of marriage should have a comprehensive fertility examination and genetic testing if necessary to accurately diagnose the disease.
