ZocdocAnswersHypoechoic lesion in left testis and azoospermia, what does that mean?

Question

Hypoechoic lesion in left testis and azoospermia, what does that mean?

Hi, I am writing on behalf of my husband.We have been married for 1 1/2 years and want to have our baby.But last week we got the shock of our life which left us devastated.He went for his semen analysis and the result said total azoospermia.They didn't find any spermatozoa even in the centrifugal deposite.So the doctor told my husband for usg of scrotum and inguinal region. The result is as below > Left head and tail of epididymis is enlarge in size and hypoechoic in echotexture and shows mild increased in vascularity in head and tail of epidydymis rt testis :3.3 * 1.8 * 1.4cm lt testes : 3.3 * 2 * 1.4 cm Conclusion: Changes of chronic sub acute epididymitis involving head and tail? Chronic granulomatous infection and hypoechoic lesion with central calcification in left testis in upper pole region. What does the report read.We didnt understand what it means.Please guide.

Answer

The workup for male infertility is fairly complex and requires a number of different tests in order. Therefore, I don't think this ultrasound test alone can be interpreted without context, which will probably have already included (or will include) tests of various hormone levels. So I do recommend that you discuss these results in detail with the fertility specialist who is performing the workup for you, because they will have all of these details and will be able to give a better answer. There are a couple of things on the ultrasound worth pointing out. First, the testicles do both seem a bit on the small side. This is not a specific finding, and it could be cause by many different things. However, there seems to be a calcified area in at least one of the testicles, making the likelihood of an inflammatory process or an infection higher. This process could have affected testicle size and overall fertility. Also, there is evidence of chronic epididymitis, or inflammation of the tubes that conduct sperm from the testicles towards the urethra. This again goes along with an chronic inflammatory process as the likely cause of the infertility, but your doctor will need to provide you with more information.

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