Ultrasound in male infertility

Introduction: Ultrasonography is commonly utilized in the evaluation and diagnosis of male-factor infertility and functions as an adjunctive method for use with assisted reproductive techniques. In addition to the ability to visualize anatomic detail in real time, enhancements of Doppler, power Doppler, and duplex Doppler provide information on underlying physiologic and pathologic processes. Methods: A PubMed literature review was performed of indexed articles relating to the use of ultrasonography in the evaluation and treatment of male-factor infertility. Treatment results and outcomes are reported where available. Results: Scrotal and transrectal ultrasonographies assist in differentiating various etiologies for infertility including infectious, benign, and malignant processes of the epididymis, testicle, prostate, and seminal vesicles. Ultrasonography helps to differentiate between obstructive and nonobstructive oligo-/azoospermia and may identify conditions associated with infertility including renal anomalies and testicular malignancies. Although there is currently minimal data on the use of ultrasonography in sperm extraction procedures, limited reports have suggested potential utility to enhance outcomes at the time of sperm extraction. Conclusions: Ultrasonography provides significant information for both the initial evaluation and diagnosis of male-factor infertility and may be used concomitantly at the time of surgery for the management of select obstructive etiologies. As ultrasound technology continues to improve, it may potentially play an increasingly central role in the management of the infertile male.