Role of Shear Wave Elastography in Evaluation of Testicular Stiffness in Male Infertility

To study the quantitative testicular tissue stiffness values in normal and infertile men using ultrasound (US) shear wave elastography (SWE) technique and to evaluate the relationship between abnormal semen analysis and testicular stiffness value. A total 60 patients (30 with male infertility and 30 normal controls) referred for scrotal US to the Department of Radiology and Imaging Sciences, Sri Ramachandra Institute of Higher Education and Research, Chennai, India, from January 2022 to January 2023 were prospectively analyzed. Testicular volume and mean SWE values in patients with infertility and normal controls were analyzed. A relationship between male infertility, semen analysis, and testicular stiffness values was established. Statistical analysis was performed on the results obtained and compared with control groups. Testicular volume was found to be statistically significantly decreased in patients with infertility (7.8–10.2 mL [mean ± 2 standard deviation, SD]) as compared with the control group (13.0–17.4 mL [mean ± 2 SD]). However, the mean SWE values were statistically significantly increased in patients with infertility (20.1–24.1 kPa [mean ± 2 SD]) as compared with the control group (10.4–19.8 kPa [mean ± 2 SD]) in our study. The inverse relationship between testicular volume and mean SWE values in patients with infertility was also proved in our study. US elastography will be a complementary tool in the diagnosis of male infertility along with regular scrotal US assessment using the SWE technique. Higher elastography values/mean SWE values in patients with male infertility give us insight into the patient's testicular stiffness and help in appropriate treatment and management.