Testicular volume in infertile versus fertile white-European men

Boeri, Luca; Capogrosso, Paolo; Ventimiglia, Eugenio; Cazzaniga, Walter; Pozzi, Edoardo; Belladelli, Federico; Pederzoli, Filippo; Alfano, Massimo; Abbate, Carlo; Montanari, Emanuele; Valsecchi, Luca; Papaleo, Enrico; Viganò, Paola; Rovere‐Querini, Patrizia; Minhas, Suks; Montorsi, Francesco

doi:10.4103/aja.aja_93_20

Cited by 29 publications

(11 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In routine practice, testicular volume is estimated using the Prader's orchidometer. The mean testicular volume measured using the Prader's orchidometer in the general population is 20.0 ± 5.0 mL [15].…”

Section: Physical Examinationmentioning

confidence: 98%

Differential Diagnosis of Azoospermia in Men with Infertility

Andrade

Viana

Esteves

2021

JCM

View full text Add to dashboard Cite

The differential diagnosis between obstructive and nonobstructive azoospermia is the first step in the clinical management of azoospermic patients with infertility. It includes a detailed medical history and physical examination, semen analysis, hormonal assessment, genetic tests, and imaging studies. A testicular biopsy is reserved for the cases of doubt, mainly in patients whose history, physical examination, and endocrine analysis are inconclusive. The latter should be combined with sperm extraction for possible sperm cryopreservation. We present a detailed analysis on how to make the azoospermia differential diagnosis and discuss three clinical cases where the differential diagnosis was challenging. A coordinated effort involving reproductive urologists/andrologists, geneticists, pathologists, and embryologists will offer the best diagnostic path for men with azoospermia.

show abstract

Section: Physical Examinationmentioning

confidence: 98%

Differential Diagnosis of Azoospermia in Men with Infertility

Andrade

Viana

Esteves

2021

JCM

View full text Add to dashboard Cite

show abstract

“…Body mass index (BMI), defined as weight in kilograms by height in square meters, was measured for each patient. Testicular volume (TV) was assessed using a Prader orchidometer by the same urologist 19 . For the specific purpose of this study, we recorded the volume of each testicle and the mean value between the two sides.…”

Section: Methodsmentioning

confidence: 99%

“…Testicular volume (TV) was assessed using a Prader orchidometer by the same urologist. 19 For the specific purpose of this study, we recorded the volume of each testicle and the mean value between the two sides. Venous blood samples were drawn from each patient between 7 AM and 11 AM after an overnight fast.…”

Section: Study Cohort Variables and Outcome Definitionmentioning

confidence: 99%

Clinical parameters associated with altered sperm DNA fragmentation index among primary infertile men: Findings from a real‐life cross‐sectional study

et al. 2023

Self Cite

View full text Add to dashboard Cite

BackgroundRecurrent pregnancy loss and unexplained infertility are the current indications to test sperm DNA fragmentation according to the European Association of Urology Guidelines on sexual and reproductive health.ObjectiveTo identify a novel and better performing model to diagnose primary infertile men presenting with altered sperm DNA fragmentation and to outline its predictive ability in respect to current European Association of Urology Guidelines’ recommendations.Materials and methodsData from the latest 515 consecutive primary infertile men as for World Health Organization criteria were analyzed. Semen analysis, sperm DNA fragmentation (according to sperm chromatin structure assay), and serum hormones were considered in every patient. Altered sperm DNA fragmentation was defined with levels greater than 30%. Descriptive statistics was applied to compare patients with normal versus SDF > 30%. The new predicting model was identified through logistic regression analysis exploring potential predictors of SDF > 30% at first clinical presentation. Diagnostic accuracy between the two predictive models (European Association of Urology Guidelines vs. new) was assessed, and decision curve analyses tested their clinical benefit.ResultsOf 515, 268 (51.9%) patients had SDF > 30% at clinical presentation. Patients with SDF > 30% were older (median [interquartile range] 39 [35–43] vs. 37 [34–41] years), had lower mean testicular volume (Prader 15 [12–20] vs. 17.5 [13.5–20] and lower total motile sperm count (1.80 [0.7–13.2] vs. 11.82 [4.2–44.5] × 106), all p < 0.001. No other clinical differences were depicted. The two groups showed similar rates of history of recurrent pregnancy loss and unexplained infertility. At multivariable logistic regression analysis, age more than 38 years (odds ratio: 2.43) and baseline total motile sperm count less than 20 × 106 (odds ratio: 3.72) were associated with SDF > 30%, after adjusting for Prader < 15, history of miscarriages and unexplained infertility, all p < 0.0001. The newly identified model (unexplained infertility + history of poli‐abortions + Prader < 15 + age ≥38 years + total motile sperm count <20 × 106) showed higher accuracy to identify SDF > 30% at baseline in respect to European Association of Urology Guidelines (area under the curve: 72.1 vs. 52.7), with superior clinical net benefit use.ConclusionsThe application of the European Association of Urology sexual and reproductive health guidelines does not ensure proper identification of primary infertile men with pathological sperm DNA fragmentation. We propose a novel and better performing predictive model to identify the infertile men with altered sperm DNA fragmentation at first clinical assessment.DiscussionAs altered sperm DNA fragmentation has been widely linked with the inability to conceive, this second‐level test could be further implemented over the diagnostic workup of a broader subset of patients presenting for male factor infertility. We propose a better performing model to identify this specific category of patients.

show abstract

“…Body mass index (BMI), defined as weight in kilograms by height in square meters (kg/m 2 ), was obtained in all cases 22 . Testicular volume was assessed using Prader orchidometer estimation by the same experienced andrologist in each man, and the mean value between the two testes has been used for the specific purposes of this analysis 23 . All men underwent at least two semen analyses, sperm parameters were assessed according to the 2010 World Health Organization (WHO) reference criteria, and the mean value was used for the specific purpose of this analysis 24,25 .…”

Section: Methodsmentioning

confidence: 99%

Kidney function impairment in men with primary infertility: A case–control analysis

et al. 2023

Self Cite

View full text Add to dashboard Cite

BackgroundInfertile men have a worse overall health status than their fertile counterparts.ObjectiveWe aimed to (1) compare kidney function in men presenting for primary couple's infertility with that of fertile men and (2) assess kidney function impairment toward sperm quality in infertile men.Materials and methodsIn this case–control study, 387 consecutive white‐European infertile men were matched by age with 134 same‐ethnicity fertile men. Complete clinical and laboratory data were available for each patient. The Chronic Kidney Disease Epidemiology Collaboration function was used for estimated glomerular filtration rate calculation. Kidney functional impairment was defined as an estimated glomerular filtration rate <90 mL/min per 1.73 m2, according to the Kidney Disease Improving Global Outcomes criteria. Multivariable logistic regression analysis was used to (1) assess the association between kidney function impairment and infertility status and (2) investigate the association between kidney function and semen analysis abnormalities in infertile men.ResultsAfter matching, 34 (8.8%) infertile men depicted at least a mild unknown impairment of kidney function compared to only four (3%) fertile men, with four (3%) of the infertile presenting with an overt kidney function impairment (estimated glomerular filtration rate <60 mL/min per 1.73 m2). There were no differences in terms of age, body mass index and rate of comorbidities between the two groups (all p > 0.05). After adjusting for major confounders, infertility status was associated with a higher risk of reduced estimated glomerular filtration rate (odds ratio 3.20; 95% confidence interval 1.21–5.2; p = 0.002). Conversely, estimated glomerular filtration rate was not associated with sperm abnormalities in infertile men.ConclusionsMild kidney function impairment was found in 9% of asymptomatic and unaware men presenting for primary couple's infertility investigation. This novel finding corroborates growing data on a significant association of male infertility with a poorer overall male health status and the need for tailored preventive strategies.

show abstract

Testicular volume in infertile versus fertile white-European men

Cited by 29 publications

References 34 publications

Differential Diagnosis of Azoospermia in Men with Infertility

Differential Diagnosis of Azoospermia in Men with Infertility

Clinical parameters associated with altered sperm DNA fragmentation index among primary infertile men: Findings from a real‐life cross‐sectional study

Kidney function impairment in men with primary infertility: A case–control analysis

Contact Info

Product

Resources

About