Testicular shear wave elastography in oligo-astheno-teratozoospermic individuals: a prospective case-control study

Purpose The 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. Methods This 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. Results We 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. Conclusion SWE 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.

Automated summary

The study aimed to evaluate testicular stiffness in men with OAT and a control group using ultrasound shear wave elastography. Results showed significant differences in testicular volume and stiffness between the two groups, with men with OAT having higher testicular stiffness values. Men with abnormal semen parameters showed inverse correlations between testicular stiffness and total sperm count, sperm concentration, and progressive motility, which were not evident in the control group.