Evaluation of the diagnostic efficacy of strain elastography in infertile population with normal and abnormal semen parameters

Objective: The aim of the present study was to investigate the diagnostic value of strain elastography (SE) of testicular tissues in infertile population. We also evaluated the correlation between SE results with semen parameters and hormone profiles of the patients. Material and methods: A total of 61 patients and 122 testes were evaluated. Patients who were evaluated in an andrology outpatient clinic with the diagnosis of infertility and referred to radiology department for investigation of reproductive organs between June 2015 and January 2016 were included. Patients were divided into two groups according to semen analyses results as normal (Group 1) and abnormal (Group 2). Hormone profiles, semen analyses, B-mode, coloured Doppler ultrasonography and sonoelastography examinations were performed for each patient. Measurements of testicular volumes, resistive indices (RI) in intraparenchymal arteries, strain, strain ratio (SR) and presence of varicocele were recorded. Results: Mean age of participants was 33.7 +/- 6.3 years. Mean testicular volumes (Group 1, 19.41 +/- 4.8 mL, and Group 2, 17.64 +/- 3.62 mL) were significantly different between groups (p=0.023). Mean SRs were also different between Groups 1 and 2 (0.12 +/- 0.08 vs. 0.22 +/- 0.18, p<0.001). Testicular volumes were directly proportional with SRs in Group 1. Strain values had inverse relationship with sperm concentration and total motile sperm counts in Group 2 (p=0.01). SRs were found to be positively correlated with RI and sperm morphology in Group 2 (p<0.05). Although FSH values showed significant difference among groups, any correlation between FSH and elastographic parameters could not be displayed. Conclusion: Strain elastography results were found to be significantly different in patients with abnormal sperm counts. This technique may provide promising results, however, further large scale studies may help to clarify the value of this imaging modality in the assessment of male infertility.