Male infertility: the role of imaging in diagnosis and management

Abstract

The investigation of male infertility is assuming greater importance, with male factors implicated as a causal factor in up to half of infertile couples. Following routine history, examination and blood tests, imaging is frequently utilised in order to assess the scrotal contents for testicular volume and morphology. Additionally, this may give indirect evidence of the presence of possible reversible pathology in the form of obstructive azoospermia. Further imaging in the form of transrectal ultrasound and MRI is then often able to categorise the level of obstruction and facilitate treatment planning without resort to more invasive imaging such as vasography. Ultrasound guidance of therapy such as sperm or cyst aspiration and vasal cannulation may also be performed. This article reviews the imaging modalities used in the investigation of male infertility, and illustrates normal and abnormal findings that may be demonstrated.

Evaluation of the diagnostic efficacy of strain elastography in infertile population with normal and abnormal semen parameters

“…[2] In addition to physical examination and semen analysis, a scrotal ultrasonography (US) may help to demonstrate obstruction or testicular dysgenesis. [3] US is the first-line imaging modality used to evaluate male genital tract due to its noninvasiveness, safety and absence of exposure to radiation. [1] It is well-known that conventional US is limited to the functional analysis of testicular tissue, but elastography is a promising technique in this field.…”

Diffusion‐Weighted and Magnetization Transfer Imaging in Testicular Spermatogenic Function Evaluation: Preliminary Results

“…Infertility is a global problem, affecting 15% of the couples in the world, with male factors accounting for 50% of cases . The various causes of male infertility can be subcategorized as obstructive and nonobstructive azoo‐ or hypospermia .…”

Surgical Management of Male Infertility

“…Imaging of the scrotum and testes can be performed mainly by ultrasound to evaluate testicular volume and morphology [ 36 ]. The ASRM/ AUA Practice Guidelines do not recommend routine application of scrotal ultrasound for evaluation of the infertile male, although ESHRE guidelines do support routine ultrasound examination [ 25 ].…”