Ultrasound imaging in reproductive medicine

Research output: Chapter in Book/Report/Conference proceedingBook chapter

Abstract

One in six couples seeks help for infertility during their reproductive years. Subfertility investigations should be performed without delays (because female fertility decreases with age) and should be as noninvasive as possible. Many fertility clinics use diagnostic hysteroscopy to assess the uterine cavity and evaluate the tubal ostia. Laparoscopy is also often used to examine internal pelvic organs and to assess tubal patency. However, both hysteroscopy and laparoscopy are invasive and expensive tests which could be replaced by transvaginal ultrasound examination. Simplified ultrasound-based infertility investigation protocols have been described. The concept of a ‘pivotal’ pelvic ultrasound examination includes an examination of the uterus and uterine cavity, endometrium, ovarian morphology and follicular size, blood flow in the uterus and ovaries and hystero-contrast sonography (HyCoSy) to check tubal patency, all performed at the same examination. The late preovulatory phase of the menstrual cycle (days 8–12) is usually suggested as the optimal time to perform these examinations. Most studies involving the ultrasound techniques referred to in this chapter are classified as evidence grade B. The aim of the pivotal scan is to assess the uterus, endometrium, fallopian tubes and ovaries. Ultrasound examination is as effective a diagnostic test as hysteroscopy or laparoscopy for the diagnosis of uterine abnormalities. Normal findings at ultrasound examination of the uterus and endometrium are described in Chapter 2. Uterine size and shape may be affected by ade-nomyosis or fibroids. The shape of the uterus can be also be distorted by congenital uterine anomalies.

Details

Authors
Organisations
External organisations
  • Skåne University Hospital
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Obstetrics, Gynecology and Reproductive Medicine

Keywords

Original languageEnglish
Title of host publicationGynaecological Ultrasound in Clinical Practice
Subtitle of host publicationUltrasound Imaging in the Management of Gynaecological Conditions
EditorsDavor Jurkovic, Lil Valentin, Sanjay Vyas
PublisherCambridge University Press
Pages91-106
Number of pages16
ISBN (Print)9781107784703, 9781904752295
Publication statusPublished - 2012 Jan 1
Publication categoryResearch
Peer-reviewedYes