Dr.sathya balasubramanyam

MD DNB MRCOG (UK) FNB(Reprod med)

ULTRASOUND EVALUATION OF SUBFERTILE MALE

The diagnosis and management of male infertility are of greater importance today. This is because male infertility contributes to about half of the total infertility cases reported worldwide. According to the World Health Organisation (WHO), about 20% of the infertility cases are caused due to predominant male factors and 27% of them are due to abnormalities in both partners, putting the total male infertility cases around 50%.

Although routine history, physical examination and blood analysis figures among the investigations conducted for the condition, the role of ultrasound in determining the condition and in treatment procedures are irreplaceable.

Physical causes are identified in about one-third of the total cases identifies as male infertility and the remaining are diagnosed with idiopathic male infertility. Primary hypogonadism characterised by testicular dysfunction or failure is considered as one of the most common cases of subfertility condition in men. Imaging techniques are significant in the identification of treatable congenital disorders or anomalies in men, which causes issues such as an obstruction in sperm delivery.

Ultrasound imaging is ideal for assessing the presence of reversible pathologies of obstructive azoospermia, testicular volume, morphology or other abnormalities in the male reproductive system. Treatment therapies that require sperm aspirations such as IVF (In Vitro Fertilisation) or ICSI (Intracytoplasmic Sperm Injection) are conducted with the assistance of ultrasound as well. Ultrasound helps in the selection of the best treatment method to overcome the subfertility issue.

Ultrasound is considered the first assessment diagnostic technique in ascertaining the cause of male subfertility. In addition to prostatic anomalies, efferent ducts patency and testicular morphology, ultrasounds may be useful in the evaluation of erectile dysfunction as well. Ultrasound associated with male infertility varies as scrotal ultrasound and transrectal ultrasound.

Scrotal Ultrasound

Scrotal ultrasound is ideal as an initial examination procedure for the initial evaluation of scrotum. They can efficiently detect the abnormalities such as epididymal issues and varicocele in the peri testicular structure and testis. They can easily detect the secondary changes due to distal genital duct obstruction. Scrotal ultrasound is carried out with the help of a high-frequency linear array transducer with a frequency in the range 7 MHz to 12 MHz.

Transrectal Ultrasound

Used for the high-resolution imaging of seminal vesicles, prostate or vas deferens, Transrectal ultrasound also called TRUS, helps in the diagnosis of acquired and congenital abnormalities. This is done with the help of a high-frequency endorectal transducer. TRUS is vital in prostatic cysts aspiration as well.

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DR.SATHYA BALASUBRAMANYAM

Dr. Sathya Balasubramanyam

MD DNB MRCOG (UK)
FNB(Reprod med)
CLOUD NINE HOSPITAL

Clinical Director Fertility

SEETHAPATHY CLINIC AND HOSPITAL

Consultant Reproductive Medicine

SUNDARAM MEDICAL FOUNDATION

Consultant Reproductive Medicine

VIJAYA HOSPITAL

Consultant Reproductive Medicine


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