A 32-year-old man presented to the fertility clinic with his partner. The couple had been together for 4 years and had been trying to conceive for the past 3 years. His partner had children from a previous marriage.
On examination, he was healthy, thin and tall but had bilateral gynaecomastia. His testes felt firm and testicular volumes were 5C6 mL. He had normal pubic and axillary hair.
Investigations:
serum testosterone10.0 nmol/L (9.0C35.0)
plasma follicle-stimulating hormone45.0 U/L (1.0C7.0)
plasma luteinising hormone32.0 U/L (1.0C10.0)
chromosomal studiesmosaic pattern of 47 XXY/46 XY
semen analysisazoospermia
testicular biopsyno viable spermatozoa
What intervention is most likely to lead to conception?
A . artificial insemination by donor
B . human chorionic gonadotropin
C . intracytoplasmic sperm injection
D . pulsatile gonadotropin-releasing hormone
E . testosterone
Answer: A