Role of Imaging in the Evaluation of Male Infertility

Abstract

Infertility is defined herein as the inability to achieve pregnancy after frequently engaging in unprotected sexual intercourse for 1 year. Among infertile couples, the cause of infertility involves the male partner in approximately 50% of cases. Male infertility is usually caused by conditions affecting sperm production, sperm function, or both, or blockages that prevent the delivery of sperm. Chronic health problems, injuries, lifestyle choices, anatomic problems, hormonal imbalances, and genetic defects can have a role in male infertility. The diagnostic workup of male infertility should include a thorough medical and reproductive history, physical examination, and semen analysis, followed by imaging. The main role of imaging is identification of the causes of infertility, such as congenital anomalies and disorders that obstruct sperm transport and may be correctable. Scrotal ultrasonography is the most common initially performed noninvasive examination used to image the male reproductive system, including the testes and extratesticular structures such as the epididymis. Magnetic resonance (MR) imaging is another noninvasive imaging modality used in the pelvis to evaluate possible obstructive lesions involving the ductal system. MR imaging of the brain is extremely useful for evaluating relevant neurologic abnormalities, such as pituitary gland disorders, that are suspected on the basis of hormone analysis results. Invasive techniques are usually reserved for therapeutic interventions in patients with known abnormalities. In this article, the causes and imaging findings of obstructive and nonobstructive azoospermia are discussed. In addition to detecting treatable conditions that are related to male infertility, identifying the life-threatening entities associated with infertility and the genetic conditions that could be transmitted to offspring-especially in patients who undergo assisted reproduction-is critical. RSNA, 2017.

Small testes: clinical characteristics and ultrasonographic findings

“…Chromosomal abnormalities such as primary and secondary hypogonadism induce testicular underdevelopment [2]. Klinefelter syndrome is the most common cause of primary hypogonadism in men [2].…”

“…Chromosomal abnormalities such as primary and secondary hypogonadism induce testicular underdevelopment [2]. Klinefelter syndrome is the most common cause of primary hypogonadism in men [2]. An acquired cause of small testes is testicular atrophy, which entails testicular volume reduction of 20% compared with baseline volume or the normal contralateral testis [1,3].…”

“…An acquired cause of small testes is testicular atrophy, which entails testicular volume reduction of 20% compared with baseline volume or the normal contralateral testis [1,3]. Testicular atrophy may occur after infarction, inflammation, cryptorchidism, varicocele, or trauma [2]. Testicular atrophy is important for male infertility because it is associated with reduced spermatogenesis and reduced fertility [2].…”

<b>Degeneração testicular em touros:</b> alterações espermáticas e sua relação com a termodinâmica e hemodinâmica testicular

“…O ultrassom é importante também para o diagnóstico de doenças do sistema urinário, órgãos genitais e aparelho reprodutor do homem (WEIDNER, 1985;BEHRE et al, 1995;GRIFFITHS et al, 2007;MARTINO et al, 2014;), além de estruturas extra testiculares como o epidídimo (MITTAL et al, 2017). Na medicina veterinária é utilizado para estudo do aparelho reprodutor em bodes e carneiros (AHMAD; NOAKES; SUBANDRIO, 1991;MIDDLETON, 1993;CARAZO et al, 2014;AILUGAMI et al, 2017), garanhões (DELVENTO, et al, 1992;VARNER et al, 2000;POZOR et al, 2017) e touros (COULTER; SHORE et al, 1995;EVANS et al, 1996;BRITO et al, 2003;BRITO, 2005;BARTH et al, 2008;AHMAD et al, 2011;BRITO, 2012;TOMLINSON et al, 2017) CARRILLO et al, 2012).…”

Avaliação genômica da infertilidade masculina idiopática por azoospermia não obstrutiva

“…A investigação dessa doença complexa necessita de uma estratégia diagnóstica baseada, inicialmente, na avaliação urológica com anamnese e exame físico detalhado, associada a exames complementares que incluem perfil hormonal, avaliação seminal e exames de imagem. Naqueles pacientes nos quais essa abordagem não foi elucidativa e que apresentam alteração da concentração espermática, o aconselhamento e a investigação genética tornam-se ferramentas essenciais na rotina diagnóstica (ANAWALT, 2013;GUDELOGLU & PAREKATTIL, 2013;LEAVER, 2016;MITTAL et al, 2017).…”