Also known as testicular ultrasound, testicular sonogram, scrotal ultrasounds are done to:

• Find an undescended testicle.
• Check for fluid in the scrotum (hydrocele), fluid in the epididymis (spermatocele), blood in the scrotum (hematocele), distended scrotal vessels (varicocele) or pus in the scrotum (pyocele).
• Guide a biopsy needle for a testicular biopsy. This may be done when testing for infertility.
• Find or check for an infection or swelling of the testicles or epididymis.
• Check for a mass or pain in the testicles.

Ultrasound of the scrotum is helpful for finding abnormalities such as masses in the scrotum or testicles, hydrocele, and varicocele all of which may affect sperm production. However, it does not always permit an exact diagnosis such as the exact type of tissue a mass is composed of, especially when the mass is solid.

• Most ultrasound scanning is noninvasive (no needles or injections).
• Occasionally, an ultrasound exam may be temporarily uncomfortable, but it should not be painful.
• Ultrasound is widely available, easy to use and less expensive than other imaging methods.
• Ultrasound imaging is extremely safe and does not use any ionizing radiation.
• Ultrasound scanning gives a clear picture of soft tissues that do not show up well on x-ray images.
• Ultrasound provides real-time imaging, making it a good tool for guiding minimally invasive procedures such as needle biopsies and fluid aspiration.

Semen analysis does not provide information about the function of the sperm, but rather a basic understanding of its production and activity.

In some men with normal semen analysis, the quality of the sperm may still be compromised.

Although there is no perfect test to assess the quality of the sperm, a recently developed test called the sperm DNA Integrity assay (SDIA) or sperm chromatin structure assay (SCSA) has been used to diagnose cases of unidentified male infertility with a normal semen analysis.

This test is only performed in certain circumstances in order to diagnose problems in the development of the endometrium, called luteal phase defect, or to diagnose possible infection of the endometrial lining. This test is used to rule out precancerous growth in the uterine cells called endometrial hyperplasia or endometrial cancer.

It can be done anytime but preferably before ovulation (first part of the cycle) to avoid interference with a possible pregnancy in the uterus.