Reproductive Medicine Unit, Liverpool Women's Hospital, Crown Street, Liverpool, L8 7SS, UK
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Abstract |
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Key words: temperature/testis/thermography
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Introduction |
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The World Health Organization (WHO, 1985) advised the use of testicular temperature in conjunction with Doppler sonography in the investigation of infertile men with varicocele. There is therefore a need for a reliable, reproducible and easily applied method of testicular core temperature measurement to be used in the investigation of some infertile men. We present a new method using microwave technology for the reliable assessment of testicular core temperature. This study was designed to assess whether alterations in testicular thermoregulation could be reliably demonstrated between patients with clinically apparent varicoceles, in those with idiopathic male infertility and in fertile donors.
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Materials and methods |
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The thermographic device has previously been used in rheumatology (Fraser et al., 1987; MacDonald et al., 1994
) and forensic medicine (al-Alousi et al., 1994
) and was shown to be reliable and reproducible (Figure 1
). Measurement of testicular temperature was carried out 15 min after the removal of inguinal clothing. The room temperature was kept stable between 20 and 24°C. Examinations were carried out by two independent investigators blinded to each other's measurements and mean values of recordings for both the scrotal neck and the lower testicular core were calculated.
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In the statistical analysis, parametric data were described as mean (±SD). Unpaired t-test was used for the comparison of means. Differences between groups were analysed using 2 test. Confidence intervals (CI) were calculated at the 95% level.
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Results |
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The mean testicular core temperature (of both sides), measured at the inferior testicular pole was significantly lower in donors compared with men with varicocele, and men with idiopathic oligozoospermia. The mean temperature drop from the scrotal neck to the inferior testicular pole was significantly greater (P = 0.0001) in donors compared with men with idiopathic oligozoospermia (P < 0.0001) and men with varicocele (P < 0.001) (Table II).
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Discussion |
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The microwave thermographic device senses the natural thermal radiation from the tissues of the body. Microwaves have a wavelength of ~10 cm and are therefore able to penetrate clinically useful depths of up to 4 cm directly. The tissues of the body are relatively transparent to microwave radiation at lower frequencies. These wavelengths are therefore less dependent on external conditions and travel further in tissue so that their detection at the skin surface reflects true core temperature.
Previous human studies of varicocele and its effect on testicular temperature have generally used indirect methods to estimate intratesticular temperature, including infrared scrotal thermography (Kormano et al., 1970; Monteyne and Comhaire, 1978
; Zorgniotti et al., 1979
), simple bulb thermometers (Zorgniotti and MacLeod, 1973
), and contact scrotal thermography (Lewis and Harrison, 1980
). These methods only measure the scrotal skin temperature and are merely indirect reflections of the actual scrotal temperature with no direct assessment of the temperature in the testicular core. Studies with direct methods where sensitive needle thermistors were used proved impractical (Lewis and Harrison, 1980
; Kurz and Goldstein, 1986
). It was concluded that contact scrotal thermography provides a means for detecting relative differences in temperatures within the testes, but that absolute temperatures, as determined by thermistor probes, are ~5% lower. The data do not indicate that this difference is constant, and a simple correction factor cannot be used to compare the two methods of determining intratesticular temperature. Variable effects of environment can make scrotal skin temperature unreliable in the assessment of testicular temperature (Agger, 1971
).
In conclusion, microwave testicular thermography for the assessment of testicular core temperatures is a new technique that is safe and reproducible. The equipment described is portable. Preliminary results show altered testicular thermoregulation in a group of patients with impaired spermatogenesis. Testicular temperature profiles obtained by microwave thermography may be of value in the assessment of infertile men with or without a varicocele.
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Acknowledgments |
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Notes |
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References |
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Submitted on December 30, 1999; accepted on April 27, 2000.