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Many people with Klinefelter syndrome have no sperm seen in the ejaculate, but that does not always mean the testicles contain no sperm. In selected cases, sperm may be found directly from testicular tissue using specialist sperm retrieval surgery, most often with microdissection TESE.

Klinefelter syndrome fertility can feel confusing because semen tests often show no sperm, yet sperm may still be present in tiny areas inside the testicles. That’s why the next step usually isn’t guesswork. It’s a proper assessment with a male fertility specialist who understands genetics, hormones, sperm retrieval, and IVF.