We present a clinical image demonstrating external scrotal use of a conventional three-dimensional (3D) transvaginal ultrasound probe in an adult male undergoing infertility evaluation. Volumetric acquisition with multiplanar reconstruction and volume rendering provided intuitive depiction of epididymal configuration relative to the testis, complementing standard two-dimensional scrotal ultrasound.

Ultrasound is the primary imaging modality for evaluation of the scrotum and male reproductive tract. While high-frequency linear probes allow detailed assessment of testicular parenchyma, comprehensive visualization of epididymal anatomy and its spatial relationship to the testis may be limited using conventional two-dimensional imaging alone . This limitation is clinically relevant in the evaluation of male infertility, where epididymal abnormalities may contribute to obstructive processes We present a clinical image demonstrating a novel external scrotal application of a conventional three-dimensional (3D) transvaginal ultrasound probe. The images were obtained in an adult male undergoing infertility evaluation. With generous coupling gel and minimal probe pressure, the transvaginal probe was applied externally over the scrotum. High-resolution 2D images were first obtained, followed by volumetric 3D acquisition. The acquired dataset was analyzed using multiplanar reconstruction and volume-rendering techniques. This approach enabled clear visualization of the epididymal head, body, and tail, along with their anatomical continuity and relationship to the adjacent testis. The volume-rendered images provided an intuitive 3D depiction of epididymal curvature and spatial orientation, features that can be challenging to appreciate using standard linear scrotal ultrasound alone. Importantly, no patient discomfort, adverse effects, or technical complications were observed during the examination. This clinical image highlights the feasibility of repurposing a 3D transvaginal probe for external scrotal imaging to improve anatomical depiction of epididymal structures. While the technique is not intended to replace conventional scrotal ultra-sound, it may offer additional anatomical insight in selected infertility cases. This re-port serves as a hypothesis-generating illustration and supports further evaluation of its diagnostic utility in larger studies.

Three-dimensional (3D) ultrasound may complement conventional scrotal imaging by displaying the testis and epididymis within a single reconstructed volume. We present a volume-rendered 3D ultrasound image obtained during the infertility evaluation of an adult male. Scrotal imaging was performed using a Samsung Medison ultrasound system with an LV3-14A linear transducer. Following standard two-dimensional assessment, a volumetric dataset was acquired and reconstructed using multiplanar and volume-rendering modes. The image demonstrated an apparently small ovoid testis with a disproportionately prominent, elongated epididymis along its posterior aspect. This appearance provided an intuitive representation of the size discordance and anatomical relationship between the two structures. However, the finding is descriptive rather than diagnostic because quantitative measurements and Doppler information were not available. Interpretation should therefore be correlated with grayscale and color Doppler imaging, clinical history, semen analysis, and hormonal evaluation. Further studies are needed to determine whether quantitative 3D measurements improve male infertility assessment.

Anti-Müllerian hormone (AMH) and antral follicle count (AFC) predict ovarian response, while serial ultrasound documents the evolving antral cohort during controlled stimulation. Yet most visit-level summaries do not preserve which follicle is which across scans. We propose a dynamic ovarian recruitment phenotype, defined as a treatment-conditioned description of identity-linked antral follicle trajectories rather than a new measure of primordial reserve. Our primary, falsifiable hypothesis is that individual follicle identity contributes reproducible information about mature-oocyte yield beyond baseline predictors and the complete routine monitoring history available at the same early prediction landmark. A stringent test compares three nested models: baseline characteristics; baseline plus contemporaneous visit-level measurements, hormones and treatment exposure; and the same information augmented by identity-linked growth, persistence and synchrony, with a rank-matched pseudo-identity model as an intermediate comparator. Scans, prediction timing and modelling flexibility must be matched, with identity permutation as a negative control. A separate hypothesis asks whether any trajectory feature retains a patient-level component across comparable stimulation cycles. Spatial features are exploratory and are not evidence of primordial-follicle activation. Support requires reliable tracking, external validation, clinically relevant incremental prediction and, ultimately, evidence of benefit for a specific clinical decision. Equal performance of identity-free monitoring models, sensitivity to matching error or absent cross-cycle reproducibility would substantially weaken the proposed phenotype. This essay offers an operational definition and a validation pathway, not new clinical data or treatment recommendations.