The Diagnostic Value of a Routine Genito-Urinary Ultrasound Examination for Men Attending an Infertility Clinic

Introduction: This study examines the value of genito-urinary ultrasound examination in the evaluation of infertility in a group of 1203 men attending an infertility clinic over a period of 3 years. A genito-urinary ultrasound examination and a semen analysis were carried out on each of these men at or close to their first visit to the clinic. Results: Of these 1203 men, 748 (62%) had a semen analysis that was classified normal while in the remaining 455 men the semen analysis showed subnormal parameters by WHO standards. A wide range of abnormalities were detected that included 5 cases of testicular cancer, 66 cases of testicular microlithiasis, 15 men with cystic ectasia of the rete testis and 52 men with lesions of the renal tract. Varicoceles were highly prevalent at 52% of men, although less than half (45% of men with varicoceles) showed subnormal semen profiles but 15% displayed ipsilateral testicular volumetric reduction ≥5mls. Semen analysis showed a low positive predictive value PPV, with the ultrasound findings (43%).