Central role of ultrasound in the evaluation of testicular function and genital tract obstruction in infertile males.
Adult
Azoospermia
/ complications
Case-Control Studies
Follicle Stimulating Hormone
/ metabolism
Genital Diseases, Male
/ complications
Humans
Infertility, Male
/ diagnostic imaging
Male
Odds Ratio
Oligospermia
/ complications
Prevalence
Rectum
/ diagnostic imaging
Retrospective Studies
Scrotum
/ diagnostic imaging
Testis
/ blood supply
Ultrasonography, Doppler, Color
/ methods
color Doppler
male infertility
oligozoospermia
reproductive hormones
testicular vascularization
ultrasound
Journal
Andrology
ISSN: 2047-2927
Titre abrégé: Andrology
Pays: England
ID NLM: 101585129
Informations de publication
Date de publication:
09 2021
09 2021
Historique:
revised:
25
05
2021
received:
30
12
2020
accepted:
27
05
2021
pubmed:
5
6
2021
medline:
25
2
2022
entrez:
4
6
2021
Statut:
ppublish
Résumé
Scrotal color Doppler ultrasonography and transrectal ultrasonography provide crucial information about the clinical status of testes and male accessory glands. To analyze the impact of ultrasound in the evaluation of infertile males. A total of 1120 records from infertile men were retrospectively evaluated (from January 2016 up to June 2020). Data on physical examination, semen analysis, sperm culture, scrotal color Doppler ultrasonography and transrectal ultrasonography, as well as sex hormones were analyzed. Among them, 238 reports from oligozoospermic/azoospermic infertile patients (P) fulfilling the inclusion criteria were considered for data analysis. Patients were subdivided into two groups according to follicle-stimulating hormone (FSH) values (Pa with FSH < 8 U/L and Pb with FSH ≥ 8 U/L). Sixty-three fertile volunteers (mean ± SD years) were enrolled as controls (C). A higher prevalence of ultrasound abnormalities was recorded in P compared to C. Pb group had significantly lower bitesticular volume compared to Pa and C. Pa had a higher prevalence of transrectal ultrasonography abnormalities than Pb (69.9% vs. 38.4%), whereas Pb had a higher prevalence of abnormalities at scrotal color Doppler ultrasonography (60.0% vs. 28.3%, both p < 0.01). Bitesticular volume was inversely proportional to the number of altered seminal parameters and able to predict gonadotropin levels. A bitesticular volume <17 cc was associated with a higher risk of azoospermia (odds ratio = 1.799). Intratesticular vascularization was inversely correlated with gonadotropin levels and directly correlated with sperm count. A higher prevalence of prostate and seminal vesicle alterations was detected in patients and in Pa group, when compared with Pb group. Ultrasound abnormalities are correlated with seminal parameters and may guide the clinician in the diagnostic workflow of male infertility, suggesting spermatogenesis impairment or genital tract obstructions.
Sections du résumé
BACKGROUND
Scrotal color Doppler ultrasonography and transrectal ultrasonography provide crucial information about the clinical status of testes and male accessory glands.
OBJECTIVE
To analyze the impact of ultrasound in the evaluation of infertile males.
MATERIALS AND METHODS
A total of 1120 records from infertile men were retrospectively evaluated (from January 2016 up to June 2020). Data on physical examination, semen analysis, sperm culture, scrotal color Doppler ultrasonography and transrectal ultrasonography, as well as sex hormones were analyzed. Among them, 238 reports from oligozoospermic/azoospermic infertile patients (P) fulfilling the inclusion criteria were considered for data analysis. Patients were subdivided into two groups according to follicle-stimulating hormone (FSH) values (Pa with FSH < 8 U/L and Pb with FSH ≥ 8 U/L). Sixty-three fertile volunteers (mean ± SD years) were enrolled as controls (C).
RESULTS
A higher prevalence of ultrasound abnormalities was recorded in P compared to C. Pb group had significantly lower bitesticular volume compared to Pa and C. Pa had a higher prevalence of transrectal ultrasonography abnormalities than Pb (69.9% vs. 38.4%), whereas Pb had a higher prevalence of abnormalities at scrotal color Doppler ultrasonography (60.0% vs. 28.3%, both p < 0.01). Bitesticular volume was inversely proportional to the number of altered seminal parameters and able to predict gonadotropin levels. A bitesticular volume <17 cc was associated with a higher risk of azoospermia (odds ratio = 1.799). Intratesticular vascularization was inversely correlated with gonadotropin levels and directly correlated with sperm count. A higher prevalence of prostate and seminal vesicle alterations was detected in patients and in Pa group, when compared with Pb group.
DISCUSSION AND CONCLUSION
Ultrasound abnormalities are correlated with seminal parameters and may guide the clinician in the diagnostic workflow of male infertility, suggesting spermatogenesis impairment or genital tract obstructions.
Identifiants
pubmed: 34085393
doi: 10.1111/andr.13060
pmc: PMC8596694
doi:
Substances chimiques
Follicle Stimulating Hormone
9002-68-0
Types de publication
Evaluation Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1490-1498Informations de copyright
© 2021 The Authors. Andrology published by Wiley Periodicals LLC on behalf of American Society of Andrology and European Academy of Andrology.
Références
Hum Reprod. 2007 Jun;22(6):1506-12
pubmed: 17376819
Hum Reprod Update. 2015 Jan-Feb;21(1):56-83
pubmed: 25038770
Hum Reprod. 1998 Nov;13(11):3090-3
pubmed: 9853862
Lancet Diabetes Endocrinol. 2017 Jul;5(7):554-564
pubmed: 27395770
Andrology. 2020 Sep;8(5):1051-1063
pubmed: 32445591
J Urol. 2006 Jul;176(1):112-8
pubmed: 16753384
J Clin Med. 2020 May 30;9(6):
pubmed: 32486230
Reprod Biol Endocrinol. 2015 Apr 26;13:37
pubmed: 25928197
Fertil Steril. 2004 Sep;82 Suppl 1:S123-30
pubmed: 15363708
Andrology. 2018 Jul;6(4):513-524
pubmed: 30134082
Eur Urol. 2012 Aug;62(2):324-32
pubmed: 22591628
Int J Endocrinol. 2012;2012:649149
pubmed: 22319527
Andrology. 2021 Sep;9(5):1490-1498
pubmed: 34085393
Hum Reprod. 2018 Nov 1;33(11):2023-2034
pubmed: 30285122
Fertil Steril. 2017 Sep;108(3):393-406
pubmed: 28760517
Int J Endocrinol. 2013;2013:145792
pubmed: 24089610
Int J Urol. 2008 Jun;15(6):529-33
pubmed: 18430152
Curr Urol Rep. 2018 May 28;19(8):58
pubmed: 29808325
Andrology. 2017 May;5(3):414-422
pubmed: 28296254
Int Urol Nephrol. 2015 Jan;47(1):53-8
pubmed: 25331197
Andrologia. 2012 May;44 Suppl 1:26-31
pubmed: 21919940
Hum Reprod. 2016 Dec;31(12):2668-2680
pubmed: 27733531
Reprod Biomed Online. 2006 Jun;12(6):704-14
pubmed: 16792845
Andrology. 2020 Sep;8(5):1005-1020
pubmed: 32353207
Andrology. 2017 Mar;5(2):268-273
pubmed: 28125168
J Clin Endocrinol Metab. 1999 Oct;84(10):3666-72
pubmed: 10523012
Hum Reprod. 2012 Apr;27(4):974-82
pubmed: 22343552