103 Testicular Microlithiasis Defines a Subgroup of Azoospermic Men with Low Rates of Sperm Retrieval
Bibliographic record
Abstract
ABSTRACT Introduction Testicular microlithiasis is prevalent in sub-fertile men but data regarding its association with sperm retrieval rates in azoospermic men are lacking. Objective To investigate the prevalence of testicular microlithiasis and its relationship with sperm retrieval rates and histopathology in azoospermic men. Methods Eighty-six consecutive men underwent scrotal ultrasonography prior to microsurgical testicular sperm extraction (microTESE). Sperm retrieval rate, testicular histopathology, testicular size, reproductive hormone estimation, karyotyping, Y chromosome microdeletion analyses and the presence of varicocele and hydrocele were compared between men with and without testicular microlithiasis. Results In total, sperm retrieval rate was 40%. Testicular microlithiasis was detected in 12 men (14%). In this subgroup, sperm retrieval rate was only 8% (1/12) as opposed to 45% (33/74) in azoospermic men with no evidence of microlithiasis (p=0.02). Mean right and left testicular diameters were significantly lower in the microlithiasis group compared to men without microlithiasis (2.4 cm vs. 3.2 cm and 2.4 cm vs. 3.3 cm, respectively, p=0.04). There was no significant difference in any other parameter between the groups (age, FSH levels, prevalence of XXY karyotype, Y chromosome microdeletions, sonographic varicoceles or hydroceles). All eleven patients with microlithiasis and no spermatozoa found were diagnosed with Sertoli cells only on histopathology. The patient with testicular microlithiasis and successful sperm extraction was diagnosed with mixed atrophy. Conclusions Among our cohort of azoospermic men who underwent scrotal ultrasound prior to microTESE, the presence of testicular microlithiasis was associated with very low sperm retrieval rates. Larger, prospective studies should be conducted to strengthen our results. Disclosure No
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".