Infertility Imaging Services Offered

• Ultrasound of the scrotum
• Transrectal ultrasound for prostate and pelvic imaging
• MRI of the pelvis
• Penis doppler
• CT scans of the urinary tract
• Varicocele embolisation

Advancements in Imaging for Male Infertility Diagnosis and Treatment

We are specifically looking for pathologies that we know can have a negative effect on spermatogenesis such as varicoceles and malignancies.
Trying to diagnose obstruction, so procedures can be planned to reconstruct and help achieve normal fertility is always the aim.
We use very specific uroradiologists who are very experienced and understand male infertility and what we are looking for.

Infertility Imaging Session Overview. Unique Aspects of Our Imaging Services

There are very few urologists who specialise in male infertility and even fewer radiologists who know anything about the pathologies associated with sperm and testicle abnormalities. It is vital that your time and money is well spent and Pippa and her team will work hard to ensure you have the highest level of care.

Patient Comfort and Safety During Imaging

Our radiologists will take several steps to make intimate imaging more comfortable for patients:

Clear Communication: The team will communicate openly and clearly with the you about what to expect during the procedure. During the examination, the purpose of the imaging and the steps involved will be discussed.

Privacy and Dignity: Each patient should feel respected and your privacy maintained throughout the scan.

Empathy and Compassion: Empathy and understanding of your concerns should be addressed at all times.

Warmth and Comfort: The environment should be warm and comfortable at all times.

Sensitivity to Cultural Differences: These will be accommodated as much as possible.

Follow-Up and Support: Miss Pippa Sangster will follow-up discussing the results and addressing any additional concerns you may have.

Detailed Examination Procedures in Infertility Imaging

Ultrasound of the scrotum

A scrotal ultrasound is a non-invasive imaging test that uses high-frequency sound waves to create images of the scrotum and its contents, including the testicles, epididymis, and surrounding structures. This test is carried out by one of our specialist uro-radiologists who have a keen interest in infertility.

During the examination, the radiologist will specifically look at:

Assessment of Testicular Anatomy: A scrotal ultrasound allows visualization of the size, shape, and structure of the testicles. Abnormalities such as testicular atrophy, masses, cysts, or other structural abnormalities can be identified. These findings can be indicative of conditions that may affect fertility, such as testicular torsion, varicocele, or testicular cancer.

Please click on the link for more information on infertility and testicle cancer.

Evaluation of Blood Flow: Doppler ultrasound, a specific type of ultrasound, can assess blood flow within the testicles and surrounding structures. Changes in blood flow patterns, such as decreased blood flow or presence of varicoceles (dilated veins within the scrotum), can be associated with infertility. 

 Varicoceles, in particular, are a common cause of male infertility and may be identified through ultrasound evaluation – please click on the link here to read more about varicoceles and infertility.

Epididymis: The epididymis is a structure located behind the testicle where sperm mature and are stored. Ultrasound can visualize the epididymis and identify any abnormalities such as cysts, inflammation, or obstruction, which may impact sperm production or transport.

Obstructions: During the examination, the radiologist will specifically be looking for signs of obstruction within the man’s reproductive tract which may be the cause of an abnormal sperm count.  These obstructions can be congenital (present from birth) or acquired (possibly from an infection) and can contribute to infertility.

 Transrectal Ultrasound: A transrectal ultrasound (TRUS) is a specialised imaging technique used to evaluate the male reproductive organs, particularly the prostate gland and seminal vesicles, by inserting an ultrasound probe into the rectum. 

 We will not automatically organise this investigation for all men undergoing assessment for male infertility. It can be useful in certain cases where there is suspicion of specific conditions which increase the risk of infertility.

If a man has a low ejaculate volume (less than 1.4ml as seen on multiple semen analysis tests) this scan is very helpful looking for an obstruction around the prostate/seminal vesicles/ejaculatory duct.

During the investigation, the specilaist uro-radiologist will look at the following:

Evaluation of the Prostate: The prostate gland plays a role in semen production and ejaculation. The ultrasound can assess the size, shape, and structure of the prostate gland, in addition to picking up any abnormalities such as inflammation (prostatitis), benign prostatic hyperplasia (BPH), or stones/cysts that may cause an obstruction to the forward flow of the sperm. These conditions may impact the quality of semen or affect fertility indirectly.

Assessment of Seminal Vesicles: Seminal vesicles are paired glands located near the prostate that contribute fluids to semen. TRUS can visualise the seminal vesicles and detect any abnormalities such as cysts, obstructions, or inflammation that may affect semen quality or ejaculation.

Ejaculatory Duct Obstruction: Ejaculatory duct obstruction (EDO) is a condition where the ducts that transport semen from the seminal vesicles to the urethra are blocked or obstructed. The rectal scan will particularly be looking  for cysts or calcifications within the ejaculatory ducts.