Abstract
PurposeThe primary objective of this study was to evaluate the testicular stiffness by ultrasound shear wave elastography (SWE) both in men with oligo-astheno-teratozospermia (OAT) and in control group. The secondary objective was to identify a possible correlation between semen quality with testicular stiffness.MethodsThis was a prospective case-control study. We divided the sample in two groups; Group A (case group) included men with OAT, and Group B (control group) men with normal sperm parameters. All participants had at last two semen analysis in the past 180 days (at last 90 days apart), using performed ultrasound and SWE elastography.ResultsWe analyzed 100 participants, 50 patients in Group A and 50 controls in Group B. There were statistically significant differences in term of testicular volume and testicular stiffness between two groups. Men with OAT had the testicular stiffness value higher than the controls in both sides (left testicular stiffness 21.4 ± 5.4 kPa vs 9.9 ± 1.6 kPa, p < 0.0001; right testicular stiffness 22.9 ± 4.8 kPa vs 9.5 ± 2.4 kPa, p < 0.0001). Men with abnormal semen parameters showed an inverse correlation between the mean value of testicular stiffness and total sperm count (22.15 ± 3.38 kPa, r = − 0.387, p = 0.005), sperm concentration (22.15 ± 3.38 kPa, r = − 0.244, p = 0.04), and progressive motility (22.15 ± 3.38 kPa, r = − 0.336, p = 0.01), while the correlation was not evident in controls group.ConclusionSWE is able to differentiate between testicles with spermatogenic changes from a healthy testicle. For this reason, it could be used to evaluate, in a non-invasive way, the tissue alterations of the organ.
Highlights
Infertility is estimated to affect between 8 and 12% of reproductive-aged couples worldwide [1]
We divided the participants into two groups: Group A included males aged > 18 years with abnormal semen parameters; in particular, all participants had Oligo-astheno-teratozoospermia syndrome (OAT) syndrome according to the WHO 2010 criteria [13]
The male participants in the two groups were comparable by age and BMI (p > 0.05)
Summary
Infertility is estimated to affect between 8 and 12% of reproductive-aged couples worldwide [1]. 40% of all male infertility cases are mainly caused by sperm defects [2]. Transplantation, Nephrology, Intensive Care and Pain Management, University of Federico II, Naples, Italy. Ultrasound (US) shear wave elastography (SWE) has been widely used in the past few years in the andrological field. It is an imaging modality that allows the evaluation of tissue stiffness based on the trajectory of shear wave propagation through a structure [4]. Using SWE, a quantitative measurement of the stiffness of a tissue is obtained by calculating the modulus of elasticity (or Young’s modulus) expressed in Kilopascal (kPa) or meter per second (m/s) [5]
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