ROLE OF SONOGRAPHIC IMAGING AND SPERM COUNT IN MALE INFERTILITY

Abstract

Male infertility is more importance with male factors which implicated as the cause to half of the infertile couples. Besides routine investigations ultra sonography of trans rectal and scrotal was performed to detect testicular and post-testicular etiology or abnormality. Infertility is considered one of the main public health issues.  Failure to fulfill to get pregnancy during 1 year of frequent, unprotected intercourse is known as infertility. Male factor is responsible in half of the cases, however, unexplained infertility are still classified as 15% of the cases. In the general population including people with fertility problems, about 84% of females would conceive within 1 year of regular unprotected sexual intercourse which rises 93% to cumulatively after 3 years. The male factor involved in 40% - 50% of infertility cases. Other causes like obstruction to spermatic ducts, varicocele, post radiation or orchidectomy are less common causes of oligospermia. About 60-65 % cases of male infertility Sperm factor is responsible. Therefore semen analysis and physical examination a scrotal ultrasonography (US) may help to demonstrate obstruction or testicular dysgenesis, due to its noninvasiveness, safety and absence of exposure to radiation US is the first-line imaging modality to evaluate male genital tract.  Aim: The aim of this study is to evaluate the causes of infertility in men with obstruction of the seminal tract, ultrasonography (medical imaging investigations) and also determine the critical testicular volume necessary for adequate sperm production and suggests guidelines for referral to infertility specialists. Material and method:   This is the prospective cross- section study which is carried out on  50 patients between the age group 27 to 48 years old male  visiting the ultrasound section of SVBCH Silvassa Hospital in the Department of Radiology in a period of one year.     All the patients were referred to the Department of Radiology for scrotal ultrasound from the urology clinic. All scrotal ultrasound scans were done using a Mindray DC-8 diagnostic ultrasound system with a 7.5MHz transducer in the presence of a male chaperone. Over both scrotal sacs coupling gel was applied and examination was done in both longitudinal and transverse planes. The semen sample was collected after 3-4 days abstinence by masturbation and modified 'masturbation’. The semen sample was then processed and analyzed in the laboratory.  Subjects were educated on method of collection. The semen parameters analyzed included semen volume, sperm concentration and total sperm count. Conclusion: There is essential to investigation of infertile male patients in order to identify potentially treatable infertility causes and guide therapy. Therefore small testicular size is associated with decreased sperm count as well as the testicular size increases the sperm count also increases. Scrotal USG is an important investigation in evaluation subclinical varicocele for early diagnosis and management of male infertility. Initial analysis of male infertility can be utilized by assessing the testicular size, by indirectly assessing the possible sperm count.

Key words: Male infertility, ultrasonography, sperm count, varicocele and Testicular volume