A urologist based in Sugar Land has developed a way to search for sperm inside the testicles without cutting into them first, using a two-minute ultrasound scan paired with computer analysis to build what he describes as a heat map of where viable sperm are most likely hiding. The technique is designed to replace a surgical search that has long required doctors to make incisions and probe tissue blindly, hoping to stumble on sperm cells for use in fertility treatment.
Dr. Taylor Kohn, a urologist with Baylor College of Medicine and CommonSpirit St. Luke's Hospital in Sugar Land, helped develop the approach, according to FOX 26 Houston. The station reports the scrotal ultrasound takes about two minutes, followed by a computer image analysis that finishes in roughly two hours, producing a visual map that highlights viable sperm pockets ahead of a retrieval procedure.
Brighter Spots, Fewer Cuts
On the resulting map, brighter areas are considered more likely to contain sperm than darker ones, per the station's report. Kohn told FOX 26 the approach often changes what happens once a surgeon actually goes in. “We are finding sperm quicker and more efficiently, and there is less damage to the testicle,” he said, according to the outlet.
That matters because the traditional method, surgical sperm retrieval, has required incisions into the testicles to search for individual sperm cells one site at a time. FOX 26 reports that kind of exploratory surgery can mean extensive tissue dissection, prolonged operations, and long-term testicular damage. The station also notes that traditional testicular sperm extraction can halt natural testosterone production, sometimes leading to long-term hormone therapy for patients.
A Contested Accuracy Figure
FOX 26 reports the sperm-location predictions have been evaluated in more than 120 patients with a reported 93% accuracy rate. That figure is disputed elsewhere: a separate azoospermia resource, the Azoospermia Guide, states that Kohn's ultrasound test is not yet peer-reviewed and published, and that its accuracy remains unknown. The two accounts do not agree on where the technology currently stands.
A related piece of published research offers a narrower data point. A preprint posted to medRxiv examined quantitative ultrasound in 27 men with non-obstructive azoospermia and found it discriminated sperm-positive from sperm-negative biopsy sites with an area-under-curve value of 0.93, with a confidence interval of 0.85 to 0.99. That AUC figure is a different statistical measure than the 93% accuracy rate FOX 26 cites, and the available evidence does not establish whether the two results describe the same patients or the same analysis. The study's own authors wrote that further validation in larger cohorts, along with assessment of variability within individual patients, is still needed.
Free Access Through a Clinical Trial
For now, the mapping protocol is offered free of charge to eligible patients participating in an ongoing clinical trial at Baylor College of Medicine in Houston, the station's report notes. Couples interested in screening for the trial can call the Baylor Medicine Urology Clinic at 713-798-4001.
Researchers are working through regulatory approvals needed to bring the technology to market, with plans to expand access to hospitals nationwide, a process FOX 26 reports is expected to take three to four years.
Part of a Broader Push for Better Tools
Kohn's work lands amid a wider search for less invasive, more precise ways to locate sperm in men with severe infertility. A separate medRxiv paper looked at 135 testicular regions of interest drawn from 37 men, including 18 with azoospermia and 19 with sperm present in the ejaculate, and concluded its findings warrant further assessment and validation for sperm retrieval prognosis and potential use as intra-operative surgical guidance.
Other researchers have taken different routes to the same problem. A retrospective study out of the University of Washington, published via Translational Andrology and Urology, reviewed 220 adults who underwent fine needle aspiration mapping between January 2008 and August 2023, assessing 419 testicles total; testicular sperm was identified in 84 of those patients and not found in 136 others. That method involves systematically aspirating multiple sites in each testicle with a fine-gauge needle to cytologically identify sperm before a retrieval attempt, rather than relying on imaging alone.
A separate review covering emerging diagnostic tools for severe male infertility, published by UroToday, described a field now drawing on genomic and proteomic testing, sperm-function tests, advanced imaging, and artificial intelligence. Meanwhile, a systematic review from researchers affiliated with Johns Hopkins examined 16 studies on testicular sperm processing and found significant heterogeneity in methodologies and outcomes, concluding that the lack of standardization in outcomes and reporting impedes the establishment of best-practice protocols across the field.
