Scrotal ultrasonography and color doppler ultrasonography findings in evaluation of infertile men

In our study, we aimed to investigate the relationship between sperm analysis and intra-extratesticular ultrasonographic pathology frequency, the arterial doppler parameters such as peak systolic velocity (PSV), enddiastolic velocity (EDV), resistivity index (RI) measured from testicular artery capsular and intratesticular branches in primary infertile male patients. 118 consecutive male patients admitted to the Department of Urology, Bulent Ecevit University School of Medicine between November 2015 and April 2016, who tried to have children with their childless wifes for 1 year via unprotected intercourse and whose wifes have no female factor for infertility determined by the Department of Obstetrics included in the study. Scrotal color doppler ultrasonography was performed in these infertile male patients with the preliminary diagnosis of primary infertility, and sperm analyses were performed. One patient with recurrent urinary tract infection, nine patients with the history of varicocele operation, four patients with the history of orchiectomy and cryptorchidism were excluded from the study. 208 testes of 108 patients were evaluated. In the Department of Radiology, Bulent Ecevit University School of Medicine, scrotal ultrasonography and color doppler ultrasonography were performed in these patients to determine intra-extratesticular pathologies measuring PSV, EDV, RI from bilateral testicular artery capsular and intratesticular branches. The findings were compared to the sperm analyses. There was significant relationship between sperm analysis results and testis volumes, while there was no significant relationship between ultrasonographic pathologies and the diameters of epididymis head and corpus. In comparison between sperm numbers and capsular/intratesticular average PSV, EDV, RI, there was statistically significant relationship in all groups including azoospermic, normospermic, oligospermic patients. There was significant relationship in comparison of normospermic infertile patients with both azoospermic and oligospermic patients. In azoospermic and oligospermic patient groups, there was significant relationship for PSV and EDV, whereas there was no relationship for RI. Similarly, there was significant relationship for PSV, EDV, RI in groups classified according to the sperm motility. In conclusion, doppler ultrasonography is a noninvasive, reliable and repeatable examination for evaluation of vascular changes and estimation of sperm analysis results in primary infertile male patients and can provide useful information. Keywords: Primary infertile male patient, Color doppler ultrasonography, Sperm analysis