Ultrasound of the testes and scrotum in the diagnosis of infertility

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The problem of male infertility is quite common. Statistically, it turns out that among all couples who have problems conceiving a child, in almost half of the cases the problem is precisely male fertility. Unfortunately, it is men who look for the causes of the problem less often. Infertility does not manifest itself in any way, which is why they most often find out about the problem when they start trying for a baby together with their partner.

There are many causes of male infertility. This term should be understood as the man’s inability to father a child, despite regular unprotected intercourse for 6-12 months. Often it is women who come to the infertility clinic to look for the causes of difficulties in conceiving a child. Men take such steps much less willingly.

What are the symptoms of male infertility?

There are many factors behind male infertility. It is influenced by the general health of a man, hormonal disorders and high levels of stress. Unfortunately, they are not eager to look for the causes of the problem, which delays diagnosis and treatment.

If a man notices the following symptoms, he should see a urologist or sexologist. These are:

1. erectile dysfunction;
2. decrease in libido;
3. sexual weakening;
4. less ejaculate;
5. changes in the color and texture of the ejaculate;
6. burning sensation when urinating;
7. testicular or prostate pain;
8. small testicle size;
9. scrotal deformities;
10. pain during and after intercourse.

It should be remembered that getting the correct diagnosis is very important for the success of trying for a baby. Often times, a visit can quickly clarify where the problems with conception arose from.

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What influences the decrease in the quality of semen?

Many factors influence the quality of a man’s sperm. Various stimulants have a negative effect on semen, which is a factor that can be easily eliminated. However, there are conditions that seriously affect sperm quality and require treatment.

The factors that may affect the quality of sperm include:

1. smoking – in order to undo the effects of smoking, a man should quit smoking;
2. alcohol – when trying to have a baby, you should strongly reduce or completely eliminate alcohol;
3. drugs – taking drugs negatively affects both the erection and the quality of sperm;
4. caffeine – to maintain sperm quality, do not exceed a few strong cups of coffee throughout the day;
5. obesity – many men do not realize that excess fat is a place of accumulation of female hormones, which means that a man’s testicles can produce less sperm;
6. medications – the quality of sperm is influenced by taken antibiotics, drugs used in the treatment of gastrointestinal diseases, heart diseases and high blood pressure.

What diseases can affect male infertility?

Most often, male infertility is associated with various urological conditions. Among them are:

1. prostate hypertrophy;
2. infections of various parts of the genitourinary system;
3. epididymal varicose veins;
4. erectile dysfunction.

Other infertility conditions include:

1. flu, infections and other illnesses associated with fever;
2. hypertension – medications taken here play an important role;
3. diseases of the thyroid gland – especially hyperthyroidism and hypothyroidism;
4. diabetes;
5. genetic diseases;
6. piggy;
7. hypopituitarism / hypothalamus;
8. high levels of prolactin;
9. neoplastic diseases – infertility often occurs as a result of treatment of neoplastic diseases, because treatment (chemotherapy, radiotherapy) negatively affects the production of sperm.

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What influences the improvement of male fertility?

The quality of sperm can only be improved by diagnosing the cause and starting treatment. It is possible, for example, to restore the patency of the pathways leading sperm from the testes and hormone treatment in the case of sex hormone deficiencies. Fertility can also be improved by treating lowered libido and erectile dysfunction.

What are the standards for semen analysis?

Semen tests are very important in the diagnosis of the causes of male infertility. It is a basic test that allows you to determine, for example, the absolute number of sperm in normal, i.e. progressive movement. Their number is determined on the basis of the amount of sperm in 1 ml of semen and the percentage of sperm in normal movement. The norm is 15 million sperm in 1 ml of semen and 40% of sperm in progressive movement.

What is the role of the testes and scrotum ultrasound in the diagnosis of infertility?

Ultrasound is a non-invasive imaging test that allows you to assess the condition of the testicles and adjacent organs, e.g. the epididymis. The test is safe and painless, and it is also very simple to perform. During the ultrasound examination, you can diagnose abscesses, tumors, hydrocele and varicose veins of the testicles.

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What areas are examined during ultrasound of the testicles?

During the ultrasound of the testicles, the scrotum is examined. The scrotum is a skin bag containing the testicles, testicular sheaths, epididymis and the so-called seminal cord. The spermatic cord is the initial segment of the vas deferens, along with the nerves and all the vessels. The testicles should be 1 cm in children and about 4 cm in adult males. The examination is simple thanks to the easy access to the scrotum.

All of the areas listed above are central to the male reproductive system, where sperm is produced and male hormones such as testosterone are released.

Unfortunately, some diseases of the testicles or other closely located organs can lead to changes in the structure of the testicles or their location.

What is the ultrasound examination of the testicles and scrotum?

The ultrasound examination is an imaging examination, thanks to which it is possible to obtain an image of the examined organ obtained thanks to ultrasound. The examination is performed with the use of an ultrasound machine, the most important element of which is the ultrasound probe and the monitor.

After applying a head covered with a special gel to the body, it begins to emit ultrasounds penetrating deep into the human body. They reflect off specific structures and return to the camera. The waves reflected from individual tissues differ from each other, so it is possible to create an image that you can see on the monitor.

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What are the indications for an ultrasound of the testicles and scrotum?

The indication for ultrasound of the testicles and scrotum is the need to assess their size and proper structure. Often the test is performed on men who, during the self-examination, detected some abnormalities on the testicle, such as nodules or lumps. The indication is also testicular enlargement, swelling, injuries or pain.

The indications for an ultrasound of the testicles and scrotum are:

1. inflammation, e.g. during infection;
2. build up of fluid between the testicular sheaths, eg, a hematoma;
3. cancers;
4. injuries, e.g. testicular rupture;
5. pain / swelling in the testicles or scrotum;
6. changes in the appearance and shape of the scrotum or suspected absence of scrotal content;
7. infertility diagnostics.

How to prepare for a testicular ultrasound?

Testicular ultrasound is a simple and safe examination that does not require any special preparation. Often, a testicular ultrasound is required for a testicular biopsy. In this case, the doctor must be informed about the medications taken, including those without a prescription, and about diseases, especially those that affect blood clotting. However, it is worth remembering about loose clothes that can be easily removed.

The test does not require any diet, there is no need to fasten, the patient does not need to have a full bladder or take specific medications. In addition, it is not necessary to shave the intimate area. However, remember to put on clothes, from which the remains of the ultrasound gel can easily come off. You can take a second set of underwear. You can take the list of medications you are taking and the results of previous tests for the test.

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What does an ultrasound of the scrotum look like?

The scrotum ultrasound is performed by a qualified radiologist or other trained doctor, e.g. a urologist. This examination takes about 30 minutes.

The patient lies down on the couch on his back. The scrotum bag should be immobile during the examination, so you can support it with a towel. Before starting the examination, the doctor applies the gel to the scrotum and places the head of the apparatus on it. By applying it to different places, the doctor obtains an image of different areas, thanks to which he can accurately assess the condition of the testicles. The individual images are often printed and attached to documentation. Particular attention is paid to the size of the testicles, structure, appearance and blood flow. The examination is completely painless.

The examination is safe, but the first contact of the transducer with the scrotum may be unpleasant. This is due to the high sensitivity of these areas and the low temperature of the gel. Your doctor records any image that might be relevant to your diagnosis.

After the examination, the patient is wiped with a paper towel and can get dressed. After the examination, you can return to your duties almost immediately. The doctor gives the patient an examination with a description and discusses the results of the testicular ultrasound.

What are the contraindications for testicular ultrasound?

Ultrasound of the testicles and scrotum is a non-invasive and painless examination. There are no serious contraindications for its implementation. By doing them, we avoid harmful radiation that could damage sperm or testicular stem cells.

A contraindication to testicular ultrasound may be, in a sense, testicular pain, as well as open wounds or other skin lesions at the test site. These contraindications are due to the fact that the head must adhere tightly to the scrotum, which would aggravate the symptoms.

How much does an ultrasound of the testicles and scrotum cost?

Ultrasound of the testicles and scrotum can be performed under the National Health Fund, but reimbursement is possible in certain cases. The test can also be done privately. The price of the test is about PLN 60-100. The cost depends on the place and city where the ultrasound is performed. The study performed privately significantly reduces the waiting time for a free date.

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