Role of Sonoelastography in Predicting Positive Sperm Retrieving in Patients with Non-Obstructive Azoospermia

Abstract

Background: Infertility is an important public health problem , almost 10-30 % is due to azoospermia.
Elastography is a new ultrasound modality which simply could evaluate the internal elasticity of the testis &
finally give an idea about the presence or absence of sperms.
Objective: To evaluate the validity of sonoelastography in predicting positive sperm retrieving in patient
with azoospermia.
Patients and Methods: A cross sectional study performed in Al-Sader Teaching Hospital / fertility center
& radiology department during the period from 1st September 2017 to 1st September 2018, included 98
patients /196 testes) with azoospermia by B-mode U/S, Doppler study (RI) & Elastography (strain ratio) ,
then biopsies obtained for all patients
Results: Only (136) testes were subjected to biopsy. Testicular volume & strain ratio were the most important
factors which suggest that the testis will give a positive or negative sperm retrieving. Low volume + high
strain NSR (bad prognosis) while high volume + low strain PSR (good prognosis).
These findings of SR were 75.7% sensitive, 93% specific, with 78% and 92% positive and negative
predictive values, respectively and an accuracy of 89%.
Conclusion: Strain Elastography results have been validated and were differed significantly between
patients with abnormal sperms count than those without. This Technique provides a promising way to get
more accurate diagnostic results.