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\begin{document}

\title{Endocrine, sexual and reproductive functions in patients with
Klinefelter Syndrome compared to non-obstructive azoospermic patients.}



\author[1]{Fatih Kocamanoğlu}%
\author[2]{Bulent Ayas}%
\author[3]{Mustafa Bolat}%
\author[2]{Ummet Abur}%
\author[4]{Recep Bolat}%
\author[5]{Ramazan  Aşçı}%
\affil[1]{City Hospital}%
\affil[2]{Ondokuz Mayis University}%
\affil[3]{Gazi State Hospital}%
\affil[4]{Cevdet Aykan Mental Health Hospital}%
\affil[5]{Ondokuz Mayis University Faculty of Medicine}%


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  \date{March 13, 2025}


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\begin{abstract}
Aims: We aimed to investigate fertilization rates, quality of embryo,
pregnancy and live birth rates, endocrine, sexual function,
psychological status and quality of life of cases diagnosed with
Klinefelter syndrome (KS). Methods: Clinical findings, hormone values
and semen analyses in patients with nonmosaic KS (Group 1, n=121) and
those with non-genetic nonobstructive azoospermia (NOA) (Group 2, n=178)
were retrospectively analyzed. Sperm retrieval outcomes with
microdissection testicular sperm extraction (micro-TESE), fertilization
rates and embryo quality, pregnancy, abortion, and live birth rates were
compared. Sexual functions were assessed using IIEF-15, quality of life
was evaluated, and psychological status was assessed. Results: There was
no difference in terms of age between groups. Sperm retrieval rates was
38\% and 55.6\% in Group 1 and 2, respectively (p=0.012). Sperm
retrieval rates were higher in Group 1 before 31.5 years than in Group 2
(AUC=0.620, 0.578). Compared to Group 2, the fertilization rate was low
in Group 1, whereas embryo quality was similar. Live birth rates were
12.5\% and 23\% in Group 1 and 2, respectively (p=0.392). The education
level, libido, erectile functions, and general health satisfaction were
lower in Group 1 than in Group 2 (buraya p de\selectlanguage{polish}ğ\selectlanguage{english}eri yaz). Depression and
anxiety levels were higher in Group 2 than Group 1 (p de\selectlanguage{polish}ğ\selectlanguage{english}eri yaz).
Conclusion: Higher sperm retrieval rate has been achieved in group 1
younger than 31.5 years. Similar embryo quality is provided between
groups. Sexual dysfunction and psychiatric problems were higher in Group
1, with lower satisfaction and general health than Group 2. Patients
with KS should be monitored not only with their reproductive functions
but also with their general health status.%
\end{abstract}%



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