Summary
Definition
History and exam
Diagnostic investigations
Investigations to consider
- scrotal ultrasound with color flow Doppler imaging
- semen analysis
- serum FSH (± GnRH stimulation)
- serum testosterone
- DNA fragmentation index (DFI)
- CT abdomen/pelvis
- MRI abdomen/pelvis
- retroperitoneal ultrasound
Treatment algorithm
Contributors
Authors

Urologist
Department of Urology
Mid-Atlantic Permanente Medical Group
Baltimore
MD
Disclosures
PR declares that he has no competing interests.
Dr Pravin Rao would like to gratefully acknowledge Dr Miguel Pineda, Dr John C. Thomas, and Dr Wayne Kuang, previous contributors to this monograph. MP, JCT, and WK declare that they have no competing interests.
Peer reviewers
Assistant Professor
Division of Pediatric Urology
University of Utah
Primary Children's Medical Center
Salt Lake City
UT
Disclosures
SO declares that she has no competing interests.
Assistant Professor
Pediatric Urology
Medical College of Georgia
Augusta
GA
Disclosures
JD declares that he has no competing interests.
Assistant Professor
Department of Urology
Head
Section of Male Infertility and Andrology
University of Wisconsin School of Medicine and Public Health
Madison
WI
Disclosures
DHW declares that he has no competing interests.
Director
Center for Male Fertility
Glickman Urological and Kidney Institute
Cleveland
OH
Disclosures
ES declares that he has no competing interests.
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