ULTRASOUND-DETECTED TESTICULAR MICROLITHIASIS AND ITS ASSOCIATION WITH SEMEN QUALITY IN INFERTILE MEN FROM THE PESHAWAR REGION

Abstract

Background: Testicular microlithiasis (TM) is an ultrasonographic finding characterized by multiple tiny echogenic foci within the testicular parenchyma. It is frequently incidental, but its clinical significance in male infertility remains uncertain because published findings on semen quality are inconsistent and regional data from Pakistan are limited.

Objective: To determine the prevalence of ultrasound-detected TM and evaluate its association with semen quality among infertile men from the Peshawar region.

Methods: A descriptive cross-sectional study was conducted at Northwest General Hospital & Research Center, Peshawar. The study included 92 infertile men with documented scrotal ultrasonography and complete semen analysis records. Demographic, clinical, lifestyle, ultrasound, and semen data were collected using a structured form. Descriptive statistics and Spearman's rank correlation were used, and p < 0.05 was considered statistically significant.

Results: The mean age was 36.07 ± 5.77 years (range, 23-49 years). TM was present in 75 of 92 participants (81.5%) and absent in 17 (18.5%). Heat exposure was reported by 60 (65.2%), smoking by 43 (46.7%), previous infertility treatment by 69 (75.0%), and current medication use by 75 (81.5%). TM showed statistically significant positive correlations with sperm count category (ρ = 0.382, p = 0.024), motility category (ρ = 0.447, p = 0.008), and morphology category (ρ = 0.371, p = 0.031). The strongest observed association was with sperm motility.

Conclusion: TM was common in this cohort of infertile men and was significantly associated with the recorded semen-quality categories. The associations were mild to moderate and should be interpreted in the context of the cross-sectional design, the absence of a fertile control group, and the clinical characteristics of the study population. TM should therefore be assessed together with semen analysis, clinical history, and other infertility findings rather than used as an independent indicator of reproductive function.