“Sonographic Evaluation of Male Infertility in Patients Attending Urology Outpatient Department at Tertiary Care Centre – A Prospective Observational Study”

Background: Infertility is growing at an alarming pace, especially in the urban areas. Regardless of color, ethnicity, or other factors, it affects between 15% and 20% of people worldwide who are of reproductive age. In India, primary infertility prevalence is between 3.9 to 16.8%, according to World Health Organization. According to recent research on the situation of infertility in India, male reproductive abnormalities or illnesses account for almost 50 percent of infertility cases. Etiologies of male infertility are generally underestimated, ignored, under-diagnosed and under-treated. This observational study evaluated male infertility patients by using Trans Rectal Ultrasound (TRUS) and Trans Scrotal Ultrasound (TSU). Method: The current prospective observational cross-sectional study was carried out at the Government Tertiary care center over the course of 18 months, from 2018 to 2020. Serum FSH was obtained for all patients (ref. range- 1.4-14.6 mIU/mL). Bilateral testes, epididymides, tunica vaginalis sac, and vas deferens, were examined methodologically. The prostate-vesicular region is assessed at transrectal US (TRUS) in transverse, longitudinal, and oblique scans. The prostate, ejaculatory duct, seminal vesicles, and terminal vas deferens were call thoroughly examined. The findings of the sonograms were tabulated and analyzed. Outcome of the study: The study included 40 men (age range, 22–40) attending the urology clinic at the tertiary care center (Osmania General Hospital), Hyderabad, and diagnosed with infertility. Testicular cause was the most common etiology of infertility. Varicocele was the most common etiology among the testicular group followed by testicular atrophy. 10 out of 40 patients had an elevated FSH, and all these patients had testicular atrophy, with a P value of <0.001 (highly significant). All 8 patients (20%) with post-testicular etiology had dilated upstream ductules. Conclusion: A comprehensive evaluation of male infertility is crucial, as surgical interventions may provide a cost-effective solution and preserve the possibility of future pregnancies. Additionally, identifying the causes of male infertility through uro-radiologic assessments and screening for conditions like testicular microlithiasis can help improve the overall health and fertility of men.