Scrotal Ultrasound and duplex: This allows accurate visualisation of the testes to determine their size, blood flow, diagnose varicocele, obstruction and testis cancer.
Any man with low sperm count should have a scrotal scan because the risk of Testis cancer is 0.5–1% in infertile men Vs 0.001%- 0.01% in the general population.
In men with a history of undescended testes the risk is even higher (2–6%) even if they were brought down during childhood.
Trans-rectal Ultrasonography (TRUS): TRUS is needed if your doctor thinks that you have a blockage of the seminal ducts which run inside the prostate. This condition is called ejaculatory duct obstruction (EDO) and is a correctable cause of male infertility.