ORIGINAL ARTICLE
Year : 2021  |  Volume : 23  |  Issue : 5  |  Page : 501-509

Testicular volume in infertile versus fertile white-European men: a case-control investigation in the real-life setting


1 Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Via Olgettina 60, Milan 20131, Italy Department of Urology, Foundation IRCCS Ca' Granda - Ospedale Maggiore Policlinico, University of Milan, Via Della Commenda 15, Milan 20122, Italy University Vita-Salute San Raffaele, Via Olgettina 60, Milan 20131, Italy Department of Obstetrics and Gynaecology, IRCCS Ospedale San Raffaele, Via Olgettina 60, Milan 20131, Italy Division of Genetics and Cell Biology, Reproductive Sciences Laboratory, IRCCS Ospedale San Raffaele, Via Olgettina 60, Milan 20131, Italy Division of Immunology, Transplantation and Infectious Diseases Department of Medicine, IRCCS Ospedale San Raffaele, Via Olgettina 60, Milan 20131, Italy Department of Urology, Imperial Healthcare NHS Trust, Charing Cross Hospital, Fulham Palace Road, Hammersmith, London W6 8RF, UK

Correspondence Address:
Andrea Salonia
Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Via Olgettina 60, Milan 20131; University Vita-Salute San Raffaele, Via Olgettina 60, Milan 20131
Italy
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/aja.aja_93_20

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Testicular volume (TV) is considered a good clinical marker of hormonal and spermatogenic function. Accurate reference values for TV measures in infertile and fertile men are lacking. We aimed to assess references values for TV in white-European infertile men and fertile controls. We analyzed clinical and laboratory data from 1940 (95.0%) infertile men and 102 (5.0%) fertile controls. Groups were matched by age using propensity score weighting. TV was assessed using a Prader orchidometer (PO). Circulating hormones and semen parameters were investigated in every male. Descriptive statistics, Spearman's correlation, and logistic regression models tested potential associations between PO-estimated TV values and clinical variables. Receiver operating characteristic (ROC) curves were used to find TV value cutoffs for oligoasthenoteratozoospermia (OAT) and nonobstructive azoospermia (NOA) status in infertile men. The median testicular volume was smaller in infertile than that of fertile men (15.0 ml vs 22.5 ml; P < 0.001). TV positively correlated with total testosterone, sperm concentration, and progressive sperm motility (all P ≤ 0.001) in infertile men. At multivariable logistic regression analysis, infertile status (P < 0.001) and the presence of left varicocele (P < 0.001) were associated with TV < 15 ml. Testicular volume thresholds of 15 ml and 12 ml had a good predictive ability for detecting OAT and NOA status, respectively. In conclusion, infertile men have smaller testicular volume than fertile controls. TV positively correlated with total testosterone, sperm concentration, and progressive motility in infertile men, which was not the case in the age-matched fertile counterparts.


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