Testicular Microlithiasis among Infertile Men: A Reason for

Testicular microlithiasis is an infrequently diagnosed condition that can be associated with a variety of pathologies of the testis, the best known of which is its association with testicular cancer. This study examines the frequency of testicular microlithiasis from a large group of men attending an infertility clinic where all men undergo genito-urinary ultrasound screening. Of 749 men, a total of 46 men were found to have testicular microlithiasis (6.1%) of which the lesion was bilateral in 39 and unilateral in 7 men. In one man, the testicular microlithiasis was found to be in association with a testicular tumour. The semen profile was categorized normal in 25 men (54%) and sub-fertile in the remaining 21 men, implying an elevated rate in this population. Testicular microlithiasis is therefore commonly seen among infertile male patients and may be a marker for serious pathology and testicular malignancy. Its presence is thus highly relevant to the assessment of infertility in the male and has implications regarding follow-up. We conclude that testicular ultrasound should be an important part of the evaluation of all males attending infertility clinics and the infertility clinicians should be aware of the condition of testicular microlithiasis.