Prioritizing Ultrasound Scrotum with Venous and Arterial Doppler as Primary Modality in Cases of Oligoasthenospermia: Original Article

Hina Anwar; Mahad Umer; Syeda Memoona; Sabahat Makhdoom; Maria Ather; Mahnoor Habib Roghani

doi:10.69885/pju.v3i1.93

Authors

Hina Anwar Urologist at SARF hospital Islamabad https://orcid.org/0000-0001-5909-912X
Mahad Umer Radiologist SARF Hospital, Islamabad https://orcid.org/0000-0002-9131-0535
Syeda Memoona Sonologist at SARF Hospital, Islamabad https://orcid.org/0000-0001-8477-6997
Sabahat Makhdoom Gynaecologist at SARF Hospital, Islamabad https://orcid.org/0009-0008-1160-3217
Maria Ather Gynaecologist at SARF Hospital, Islamabad https://orcid.org/0009-0000-3259-2918
Mahnoor Habib Roghani Senior Medical Officer at SARF Hospital, Islamabad https://orcid.org/0009-0004-3584-2854

DOI:

https://doi.org/10.69885/pju.v3i1.93

Keywords:

Oligoasthenospermia, Varicocele, Male infertility, Doppler ultrasound, Sperm motility

Abstract

Background: Oligoasthenospermia is a common contributor to male infertility and is frequently associated with varicocele and impaired testicular perfusion. Conventional semen analysis alone may not adequately identify underlying anatomical and vascular abnormalities.

Objective: To evaluate the association between sperm concentration and varicocele detected on Doppler ultrasonography among patients with oligoasthenospermia.

Methods: This cross-sectional study was conducted at SARF Hospital Islamabad from March 2024 to September 2024. Sixty male patients aged 20–32 years presenting with primary or secondary subfertility and diagnosed with oligoasthenospermia were included. Scrotal ultrasound with venous and arterial Doppler assessment was performed to identify varicocele characteristics. Semen analysis was carried out according to European Association of Urology guidelines. Data were analyzed using SPSS version 23.0. Correlation analysis was performed between sperm concentration and varicocele presence.

Results: Among 60 participants, 52 (86.7%) had primary subfertility and 8 (13.3%) had secondary subfertility. Varicocele was identified in 51 (85.0%) patients, with left-sided varicocele being the most common presentation (73.3%). Grade 3 varicocele was observed in 37 (61.7%) participants. Mean sperm concentration was significantly lower in primary subfertility cases compared to secondary subfertility cases (1.13 ± 0.34 vs 5.91 ± 4.08 million/mL). Correlation analysis demonstrated a weak positive but statistically non-significant association between sperm concentration and varicocele presence (r = 0.205).

Conclusion: Varicocele is highly prevalent among patients with oligoasthenospermia, particularly in primary subfertility. Doppler ultrasound provides valuable anatomical and vascular assessment and may serve as a useful adjunct in the evaluation of male infertility.