Ultrasound Evaluation of Male Reproductive Health
Summary
Ultrasound has become the cornerstone of non-invasive assessment in male reproductive health, enabling detailed examination of testicular structure, vascular perfusion and adjacent genital anatomy. High-resolution scrotal ultrasonography permits accurate measurement of testicular volume and echotexture, detection of varicoceles, microlithiasis and focal lesions, and evaluation of the epididymis and spermatic cord. Colour and spectral Doppler add functional insight by quantifying blood flow and resistive indices, helping to distinguish obstructive and non-obstructive infertility. Transrectal ultrasound extends evaluation to the prostate, seminal vesicles and ejaculatory ducts, uncovering obstructive causes of azoospermia. Emerging modalities such as elastography, contrast-enhanced ultrasound and automated image segmentation are refining diagnostic precision and reproducibility. Integration of sonographic findings with semen analysis and hormonal profiles enhances clinical decision-making, informs treatment selection—from varicocele repair to assisted reproduction—and underpins longitudinal monitoring in fertility clinics and andrology units worldwide.
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Ultrasound Evaluation of Male Reproductive Health publication trend
The graph below shows the total number of articles in ultrasound evaluation of male reproductive health across all publications each year (not limited to Nature Index journals).
Technical terms
Testicular volume: The three-dimensional size of the testis measured by ultrasonography, reflecting spermatogenic capacity and endocrine function.
Colour Doppler ultrasound: An imaging mode that overlays blood flow information on standard ultrasound images to assess vascular perfusion and flow direction.
Resistive index: A Doppler-derived ratio [(peak systolic velocity – end diastolic velocity) / peak systolic velocity] indicating arterial resistance within the testicular parenchyma.
Varicocele: Dilatation of the pampiniform plexus veins in the spermatic cord, detectable by venous reflux on Doppler ultrasound and associated with impaired sperm parameters.
Testicular microlithiasis: Multiple tiny intratesticular calculi seen as echogenic foci on ultrasound, sometimes linked to infertility or malignancy risk.
References
- The role of the radiologist in the evaluation of male infertility: recommendations of the European Society of Urogenital Radiology-Scrotal and Penile Imaging Working Group (ESUR-SPIWG) for scrotal imaging. European Radiology (2024).
- Advanced Sonographic Techniques in the Comprehensive Evaluation and Diagnosis of Male Infertility. Cureus (2024).
- Diagnostic accuracy of resistive index of capsular and intratesticular branches of testicular arteries in infertile men with oligoasthenospermia: A case-control study. BioMedicine (2020).
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