Ultrasensitive Doppler as a tool for the diagnosis of testicular ischemia during the Valsalva maneuver: a new way to explore varicoceles?
Ultrasensitive Doppler as a tool for the diagnosis of testicular ischemia during the Valsalva maneuver: a new way to explore varicoceles? Acta Radiol. 2018 Nov 05;:284185118810981 Authors: Rocher L, Gennisson JL, Barranger J, Rachas A, Criton A, Izard V, Bertolloto M, Bellin MF, Correas JM Abstract BACKGROUND: Varicocele is among the most common causes of male infertility because of various mechanism, including hypoxia. PURPOSE: To evaluate testicular vascularization (TV) with ultrasensitive Doppler before and during the Valsalva maneuver (VM) and correlate TV changes to varicocele's spermatic venous reflux graduated by color Doppler. MATERIAL AND METHODS: From January to February 2016, 69 men (135 testis) referred for scrotal ultrasound were prospectively enrolled. An institutional review board approved the study. As gold standard, the spermatic venous reflux in the supratesticular region was assessed with color Doppler ultrasound and graded from 0 to III. A new ultra-sensitive Doppler (USD) sequence was performed on testicular parenchyma in an axial view. The TV changes before and during the VM were qualitatively graded from 0 to 2 using a visual scale by consensus. The vessels surface was quantified using customized MATLAB® software, and compared to the testicular delineated surface, resulting in a vessels surface ratio (VSR). The absolute and relative VSR difference before and during the VM was calculated. The qualitative scale and the ...
We present MRI and CT case examples, together with corresponding laparoscopic and histopathology images to enhance radiologists ’ understanding of this disease.
ConclusionsOur results indicate that men with CUAVD mainly display oligozoospermia or normozoospermia and that they were previously fertile. They clearly confirm, first, thatCFTR testing is recommended in CUAVD men and it should be mandatory for those with normal kidneys; and, second, that TRUS is needed for the diagnosis of CUAVD. As CUAVD may be present whatever the sperm count, biological warnings are represented by semen volume and seminal epididymal markers, and clinical warnings by surgical histories of undescended testes or inguinal hernia.
A 41-year-old nulliparous woman underwent assisted reproductive technology (ART) for infertility (stimulation cycles for oocyte retrieval, and embryo transfers). After two biochemical miscarriages, ultrasound and laparoscopy were performed. She reported dysmenorrhea and left sided pelvic pain. Apart from hypothyroidism, her medical history was unremarkable: of note, there was no history of laparoscopic myomectomy. Initial laparoscopy revealed “bubbles of angry-looking tissue”: biopsy reported endometriosis; cytology on peritoneal washings was negative for malignancy.
Condition: Infertility, Female Intervention: Diagnostic Test: office micro hysteroscopy Sponsor: Beni-Suef University Completed
CONCLUSIONS: In most patients, endometrial thickness on day of embryo transfer (after progesterone administration) increased or kept being stable compared with that on day of progesterone administration. An increased endometrium after progesterone administration was associated with better pregnancy outcome. PMID: 31767010 [PubMed - in process]
AbstractPurpose of ReviewThis review highlights the role of imaging in the diagnosis and management of reproductive disorders. The additional information that imaging studies can contribute to reproductive medicine is emphasized, including the role of pelvic ultrasonography (US, including sonohysterography and contrast-enhanced hysterosalpingosonography), hysterosalpingography (HSG), and magnetic resonance imaging (MRI) of the female reproductive tract. In addition, the implications of congenital causes of infertility on the urinary tract in females are reviewed.Recent Findings SummaryWhile the evaluation of infertility in...
Azoospermia, or the absence of spermatozoa in the semen, is present in up to 10% of men presenting with infertility. The majority of these men will have nonobstructive azoospermia (NOA), or impaired production of sperm. When present, testicular sperm can be used with in vitro fertilization and intracytoplasmic sperm injection to achieve fertility. One of the most effective treatment options to obtain testicular sperm is microsurgical testicular sperm extraction (micro-TESE). Reported rates of successful sperm retrieval with micro-TESE range from 40% to 60%.