{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T02:20:10Z","timestamp":1784946010740,"version":"3.55.0"},"reference-count":36,"publisher":"S. Karger AG","license":[{"start":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T00:00:00Z","timestamp":1770854400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T00:00:00Z","timestamp":1770854400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Urol Int"],"abstract":"<jats:p>Introduction: To develop a preliminary, decision-making protocol capable of predicting sperm retrieval success in non-mosaic Klinefelter\u2019s syndrome (KS) patients. Main outcome measure was to identify predictors of successful sperm retrieval and to build a decision-making protocol capable of predicting this success by assessing several variables including age, testicular volume, and preoperative hormonal responses. Methods: A retrospective cohort study included all men with non-mosaic KS who were treated with recombinant hCG and then underwent microdissection testicular sperm extraction (micro-TESE) between December 2019 and March 2023. Results: Thirty-eight patients who were treated medically with rec-hCG prior to their micro-TESE were included. Sperm was retrieved successfully from 28 (73.7%) patients. Initial testosterone differences between the groups were small and not significant, the mean pre-op (post-hormonal treatment) testosterone between the two groups was significant (p = 0.001). We then built a decision-making tree, in which testosterone change was the primary determining factor for successful sperm retrieval, testicular volume was a contributory secondary variable, and age was a tertiary consideration in cases of low testicular volume. Using this model, we observed the highest success rates (97%) in men with testosterone change of 9 nmol\/L or more and testicular volume of 3 cc or more. on the other hand, men with no testosterone change with hormonal treatment, low testicular volume who were 25 years old or more had a success rate of only 63%. Conclusion: This study proposes a preliminary, decision-making protocol capable of predicting sperm retrieval success in non-mosaic KS patients. This model can be used as part of an individualized counseling approach. External validation is essential to corroborate our preliminary results.<\/jats:p>","DOI":"10.1159\/000550813","type":"journal-article","created":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T17:00:54Z","timestamp":1770915654000},"page":"1-9","source":"Crossref","is-referenced-by-count":1,"title":["A Novel Decision-Making Protocol for the Prediction of Sperm Retrieval in Klinefelter\u2019s Syndrome 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