SynthesisReproductive biology and endocrinology : RB&E2025
Testicular microlithiasis and male fertility: a dual perspective integrating imaging and physiological insights.
Synthesis in Reproductive biology and endocrinology : RB&E, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
2 citing papers in PubMed.
- Sizing up Testicular Masses: Clinical Implications of Lesion Size and Contralateral Biopsy.Cancers · 2026Article
- From incidentaloma to actionable insight: a clinical-molecular-imaging framework for risk-stratified management of testicular microlithiasis.Frontiers in endocrinology · 2026Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTesticular microlithiasis (TM) is a pathological condition characterized by diffuse calcifications within the seminiferous tubules. Its clinical significance remains controversial. While some studies regard TM a benign imaging finding, others suggest potential associations with impaired fertility and an increased risk of testicular malignancy.
objectiveThis study aims to systematically review the existing evidence regarding the relationship between TM and male fertility, incorporating both imaging and physiological perspectives.
methodsA systematic review was conducted in accordance with PRISMA guidelines. We searched the PubMed, Embase, and CNKI databases from 2003 to 2025 using the keywords "testicular microlithiasis" in combination with "fertility," "spermatogenesis," and "semen analysis." The inclusion criteria comprised clinical studies evaluating TM in the context of male fertility, including imaging techniques, physiological mechanisms, case-control studies, cohort studies, cross-sectional studies, and narrative reviews. Conference abstracts and animal studies were excluded from the review. After rigorous screening, 66 high-quality studies were included for synthesis and analysis.
resultsThe prevalence of TM was significantly higher in infertile men (5.54%) compared to the fertile population (1.47%), reinforcing the potential link between TM and male infertility. Bilateral TM was strongly associated with reduced testicular volume, lower sperm retrieval rates, and abnormal semen parameters, indicating a more pronounced detrimental effect on reproductive function. Imaging and physiological data suggest that scrotal ultrasonography, used as the primary diagnostic tool, frequently reveals an elevated testicular resistive index (RI) in patients with TM. Concurrent findings include damage to the seminiferous tubules, aberrant expression of fertility-related genes such as KITLG and BMP7, and dysregulation of the testicular microenvironment, which may underlie impaired spermatogenesis. Additionally, in high-risk populations, TM has been linked to an increased risk of testicular germ cell tumors.
conclusionsIndividuals with bilateral TM and testicular atrophy should be classified as high-risk and closely monitored through routine ultrasound evaluations. Assisted reproductive technologies, such as microdissection testicular sperm extraction (micro-TESE), may be necessary to optimize fertility outcomes. Future research should prioritize large-scale prospective cohort studies and interdisciplinary approaches to elucidate the molecular mechanisms underlying TM and to advance personalized treatment strategies.
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