The incidence and significance of testicular microlithiasis in a subfertile population

The objective of this study was to assess the frequency of testicular micro lithiasis (TM) in infertile men who underwent testicular ultrasound and to determine any causative or associated factors. The case notes of 159 consec utive patients who were referred for testicular ultrasound in the investiga tion of male factor infertility were reviewed. Microcalcification was found in 10 cases (6.2%). This was unilateral in ail cases and six patients had clinical evidence of a varicocele. Five cases had minimal calcification and five had marked TM. One patient had a past history of testicular maldescen t and another of testicular torsion. Sperm function (as assessed by sperm c ount, motility and the sperm migration lest) was variable within the 10 pat ients and there was no correlation with hormone profiles or testicular size . There was a statistical difference between a number of investigations in those patients with minimal degrees of calcification and those with TM (spe rm migration test (SMT), namely sperm migration and sperm motility (p<0.05, Mann-Whitney U test)). The results showed a higher than expected incidence of TM. Patients with marked TM seemed to have poorer sperm function than t hose with minimal calcification. There was a high incidence of co-existing pathology, for instance scrotal varicocele and cryptorchidism, although the numbers in this study were small and further studies need to be carried ou t to determine the exact nature and significance of this condition.