The potential causes of male infertility are numerous and diverse. For some, a few lifestyle adjustments and simple medications suffice, but for others a more thorough investigation is warranted. While ultrasound has long been an essential tool in female fertility investigation, it has application in males as well. Namely, in cases where simple physical examination may not reveal any issues, scrotal ultrasound may hold the answers.

Scrotal ultrasound is an imaging technique that utilizes high-frequency sonic waves to visualize the internal structure of the scrotum and testes. The method involves no invasive procedures or ionizing radiation and is completely painless.

During this examination, the scrotum and surrounding structures are thoroughly investigated. The should waves allow for a detailed investigation of the anatomy, vasculature and blood flow of the testis. Abnormalities in these areas may be the underlying cause of infertility and they may be reversible. In particular, the following are meticulously investigated:

  • Unusual scrotal mass
  • Signs of trauma or damage that compromise the anatomical integrity of the structures in the area
  • Evidence of internal inflammation
  • Irregular shape of the testicles
  • Vascular irregularities (varicocele)
  • Tissue irregularities (abnormal echotexture)

Abnormal ultrasound findings may be further investigated by testicular biopsy in order to ensure that sperm production is normal. Vascular irregularities discovered by ultrasound may be surgically corrected to restore normal blood flow and the anatomy of the area.

In cases of increased clinical suspicion for abnormalities in the male reproductive track downstream of the testes (prostate, seminal vesicles, ejaculatory ducts etc), a transrectal ultrasound may be recommended to complete the reproductive tract investigation.