Patients with infertility often presents alterations at ultrasonographic examination of the
testis. These alterations include a much higher incidence of small, multiple, non-palpable
hypoechoic micro-nodules that can show internal vascularization. This finding often create
alarm and anxiety, because it has to be placed in a differential diagnosis versus low-stage
malignant germ cell tumors. Nevertheless, explorative surgery reveal that a consistent number
of these lesion are benign, due to Leydig cell hyperplasia or Leydig cell tumours. The
purpose of this study is to evaluate the effects of androgen therapy on the size and number
of non-palpable hypoechoic micro-nodules in patients with elevated gonadotropin levels.