Testis ultrasound in Klinefelter syndrome infertile men: making the diagnosis and avoiding inappropriate management
Purpose : Klinefelter syndrome is the most common chromosomal aberration among azoospermic men. We wanted to compare testicular echogenicity and intratesticular arterial blood in men with this syndrome versus men with normal sperm parameters. Methods : Testicular sonography including Doppler imaging, was performed as part of the infertility workup in 26 men with Klinefelter syndrome as well as in 26 men with normal sperm parameters. Results : In men with Klinefelter syndrome, sonography of the testicular parenchyma revealed a heterogenous irregular pattern with spread hyper- and hypoechoic foci. Doppler sonography resulted in waveforms of high impedance patterns, reflecting intratesticular blood flow of a high resistance. In men with normal sperm parameters testicular echogenicity was of an almost homogenous regular pattern. In these men, intratesticular blood flow typically exhibited a pattern of low vascular resistance. Conclusions : The study demonstrates that testicular echogenicity as well as intratesticular blood flow are different in men with Klinefelter syndrome versus men with normal sperm parameters.