Testicular Ultrasound

A testicular ultrasound exam (also referred to as a scrotal ultrasound) is non-invasive procedure for checking whether or not a physical abnormality in the testicles is making a man infertile. It can be described as a fertility test. When male factor infertility is suspected, it's quite common for a doctor to recommend this type of ultrasound.

How It Works

A small device called a transducer is moved around on the surface of the scrotum. This device passes high frequency sound waves through the testicles. These waves are reflected back to a detector which converts them into images, which are displayed on a video screen. Records of these images are kept to be examined by a doctor, who can look at them and decide whether or not it seems that anything is wrong inside the testicles.

What The Exam May Find

The kinds of physical problems which may show up in a testicular ultrasound examination include, among others:

Varicocele - this is an enlargement of the veins in the scrotum (the bag of skin which contains the testicles). The condition is quite similar to varicose veins, which affect the legs. Varicocele can cause low sperm production and the production of poor quality sperm, although the medical experts still don't really know why. One theory is that the enlarged veins stop the blood in the testicles cooling off, and that this increase in temperature hampers sperm production.

Swellings and obstructions - obstructions may be present in the ejaculatory ducts, preventing normal ejaculation, as well as in the epididymis. The epididymis is a long, tightly coiled tube that is located behind each one of the testicles. This is where sperm cells are stored. If this tube is obstructed, sperm cells may not be able to find their way out of the testicles and into the semen ejaculated when a man has sex.

Prostate gland abnormalities - some problems with the prostate gland can also cause infertility. Twists or blockages in the vas deferens, the tube that connects the testicles to the prostate gland, come into this category.

The Procedure

The testicular ultrasound procedure is typically carried out by a trained ultrasound technologist, not by a doctor. The results are passed on to a radiologist, an urologist, or a male fertility specialist for the purpose of diagnosis.

Before the exam begins, the patient will have to remove all clothing from the waist down. A blanket or some towels are usually provided for the sake of modesty. With the patient lying on his back, some lubricant gel will be smeared onto the scrotum to enable to transducer to be moved back and forth without causing any discomfort.

The patient will be asked at various times to take deep breathes and hold them for a few seconds. The back and forth movement of the transducer may continue for around 20 minutes.


When it's over, the patient may be sent to the doctor for immediate interpretation of the results - but usually only if the ultrasound technologist believes he has found something that requires immediate attention. A follow-up appointment in a few days' time is more likely.

There are possible medical solutions, including surgery, to many of the problems which may be detected in a testicular ultrasound exam. It's important to try and stay focused on finding a solution, not on the problem itself, no matter what the result.

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