Imaging Modalities in the Management of Male Infertility

Chapter

Abstract

Infertility affects approximately 15% of couples desiring conception, and male infertility underlies almost half of the cases. Assisted reproductive techniques (ART) are increasingly being used to overcome multiple sperm deficiencies and because of their effectiveness have been suggested by some to represent the treatment for all cases of male factor infertility regardless of etiology. Although the use of these technologies may allow infertile couples to achieve pregnancy rapidly, associated higher cost, potential safety issues, and considering the fear of transferring the unnecessary burden of invasive treatment on healthy female partners weigh down this treatment option heavily. Diagnostic imaging techniques may be indicated as part of the complete male fertility evaluation. Productive therapy can be instituted only after completion of a thorough evaluation that begins with a detailed, direct history and physical examination. Due to the introduction and enhancement of newer imaging modalities, reliable adjuncts to clinical examination can be obtained to diagnose a variety of causes of male infertility including varicocele, epididymal blockage, testicular microlithiasis, seminal vesicle agenesis, and ejaculatory obstruction. Imaging plays a key role in the evaluation of the hypospermia or azoospermic man. It can detect correctable abnormalities, which can lead to a successful conception. It can also reveal potentially life-threatening disorders in the course of an infertility evaluation as testicular tumors. The goal of this chapter is to provide the reader with a foundation for a comprehensive evaluation of the male partner as well as emerging technologies that can improve the treatment of correctable causes of male infertility.

Keywords

Imaging in male fertility Assisted reproductive techniques Testicular tissue imaging Doppler duplex flow imaging MRI spectral imagine Testicular artery mapping Varicocelectomy Ejaculatory duct imaging Testicular microlithiasis 

Notes

Acknowledgments

The authors are grateful to Ashok Agarwal, Cleveland Clinic, for his support and encouragement.

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Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  1. 1.Department of UrologyUniversity of Sao Paulo (USP)Sao PauloBrazil
  2. 2.Division of UrologyWinter Haven Hospital University of Florida, Winter HavenWinter HavenUSA

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