DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20150693

Application of ultrasonography in female infertility: a comprehensive review

Tochukwu C. Okeke, Kennedy K. Agwuna, Cyril C. Ezenyeaku, Lawrence C. Ikeako

Abstract


The quest for detailed evaluation of the uterus, fallopian tubes, and ovaries that is radiation free, inexpensive, readily available, non-invasive, relatively less time consuming and easily repeatable in female infertility has resulted in further studies. However, ultrasonography (US) remains the first line indispensable tool for gynecologic workup, monitoring and treating infertility. The aim is to review the current knowledge regarding the application of ultrasonography in female infertility. This was a descriptive review of ultrasonography in female infertility. We searched several databases (Medline, Google scholar, PubMed) with keywords “ultrasonography and female infertility”, “evaluation of female infertility”, “role of ultrasonography in female infertility:, and imaging in female infertility”. Female infertility is multifactorial in origin. Ultrasonography is the most widely used imaging in gynecology and has revolutionized the management of female infertility worldwide. The recognition, evaluation and treatment of female infertility are complicated, complex, stressful and emotionally devastating for most couples. The couple’s emotional state should be supportive, informative and well tolerated. Female infertility is an immense stress to couples, families and relatives worldwide. The causes are multifactorial in origin with both congenital and acquired problems of the uterus, fallopian tubes and ovaries. Ultrasound plays an important role in female infertility workup with hysterosalpingography (HSG), sonohysterography (Sono-HSG) and magnetic resonance imaging (MRI), each playing a complimentary role in the screening, diagnosis and/or management of female infertility.


Keywords


Female Infertility, Ultrasonography, HSG, Sono-HSG, MRI

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References


Okeke TC, Ezenyeaku CCT, Ikeako LC. A review of treatment options available to women with uterine fibroids. British Journal of Medicine and Medical Research (BJMMR). 2015;6(12):1136-48.

Balogun SK. Age as correlate of incidence of vesico-vaginal fistula (VVF): The Nigerian example. Issues Health Psychol. 1995;2:44-51.

Cousineau TM, Domar AD. Psychological impact of infertility. Best Pract Res Clin Obstet Gynaecol. 2007;21:293.

Haq IU, Mauzur S, Rehman AU, Farooq A. Role of ultrasonography in infertility management: Ovulation monitoring and assisted conception Annals. 2010;16(4):257–61.

Rastogi R. Role of imaging in female infertility (Dr. K.M Rai Memorial Oration Award). Indian J Radiol Imaging. 2010;20(3):168-73.

Padubidri VG, Daftary SN (eds). The pathology of conception. In: Howkins and Bourne Shaw’s Textbook of Gynaecology. 13th Edition. New Delhi, Elsevier. 2004;194-216.

Adekunle RA. Gynaecological Anatomy. In:Arulkumaran S, Synmonds IM, Fowlie A (eds), Oxford Handbook of Obstetrics and Gynaecology. 1st edition. New Delhi, Oxford University Press. 2004;453-58.

Donald I, MacVicar J, Brown TG. “Investigation of abdominal masses by pulsed ultrasound”. Lancet. 1958;1(7032):1188-195.

Woo Joseph. A short history of the development of ultrasound in obstetrics and Gynaecology ob-ultrasound.net retrieved, 2007.

Weissman A, Mcardle CR, Achiron R. Ultrasound in Infertility. In:Seibel MM(ed), Infertility A Comprehensive Text. 2nd edition. Connecticut, Appleton and Large. 1997;447-92.

Kratochwil A, Urban GU, Fredrick F. Ultrasonic tomography of the ovaries. Ann Chir Gynecol. 1972;61-211.

Hackeloer B, Nitschke S, Daume E, Sturm G, Buch holz R. Ultrasonics of ovarian changes under gonadotrophin stimulation. Geburtshilfe Frauenheilkd. 1977;38:185

Hacheloer BJ, Fleming R, Robinson HP, Adam AH, Coutts JRT. Correlation of ultrasonic and endocrinologic assessment of human follicular development. Am J Obstet Gynecol. 1979;135:122-29.

Kerin JF, Warnes GM, Crocker J, et al. 3-hour urinary radio immunoassay for luteinizing hormone to detect onset of preovulatory LH surge. Lancet. 1980;1:430.

O’Herlithy C, de Crespigny L, Robinson HP. Monitoring ovarian follicular development with real-time ultrasound. BJOG 1980;87:613.

Montzavinos T, Garcia JE, Jones HW Jr. Ultrasound measurement of ovarian follicles stimulated by human gonadotropins for oocyte recovery and in intro fertilization. Fertile Steril. 1983;40:461.

Seibel MM, McArdle CR, Thompson IE, Berger MJ, Taymor ML. The role of ultrasound in ovulation induction: A critical appraisal. Fertil Steril. 1981;36:573.

Gleicher N, Friberg J. fullan N, et al. Egg retrieval for in vitro fertilization sonographically controlled vaginal culdocentesis. Lancet. 1983;2:508.

Dellenbach P, Nisand I, Moreau L, et al. Transvaginal sonographically controlled ovarian follicle puncture for egg retrieval. Lancet 1984;2:1467.

Schwimer SR, Lebovic J. Transvaginal pelvic ultrasonography. J Ultrasound Med. 1984;3:381.

Frederick J, Paulson RJ, Sauer MV. Routine use of vaginal ultrasonography in the preparative evaluation of gynecologic patients. An adjunct to resident education. J. Reprod Med. 1991;36:779.

Yee B, Barnes RB, Vargyas JM, Marrs RP. Correlation of Transabdominal and transvaginal ultrasound measurements of follicle size and member with laparoscopic findings for in vitro fertilization. Fertil Steril. 1987;47:828.

Andreotti RE, Thompson GH, Janowitz W, Shapiro AG, Zusmer NR. Endovaginal and transabdominal sonography of ovarian follicles. J Ultrasound. 1989;8:555.

Timor-Tritsch IE. Is office use of vaginal ultrasonography feasible? Am J Obstet Gynecol. 1990;162:983.

Kaproth-Joslin K, Dogra V. Imaging of Female Infertility. A Pictorial Guide to the Hysterosalpingography, Ultrasonography, and Magnetic Resonance Imaging findings of the Congenital and Acquired Causes of Female Infertility. Radio Clin N Am. 2013;51:967-81.

Steinkeler JA, Woodfield CA, Lazarus E, Hillstrom MM. Female Infertility: A Systematic Approach to Radiologic Imaging and Diagnosis. Radiographics. 2009;29(5):1353-70.

Nguyen KT. Female Infertility. In: Sauerberi EE, Nguyen KT, Nolan RL (eds). A Practical guide to Ultrasound in Obstetrics and Gynecology. 1st edition. Philadelphia, Lippincott-Raven. 1998;104-9.

Ecochard R, Boehringer H, Rabilloud M, Marret H. Chronological aspects of ultrasonic, hormonal and other indirect indices of ovulation. BJOG. 2001;108:822.

Luttjeboer F, Harada T, Hughes E, et al. Tubal flushing for Subfertility. Cochrane Database Syst Rev. 2007:CD003778.

Goldberg BB, Liu JB, Kuhlman K, Merton DA, Kurtz AB. Endoluminal Gynecologic Ultrasound: Preliminary results. J Ultrasound Med. 1991;10:583-90.

Bassil S. Changes in endometrial thickness, Width, Length and pattern in predicting pregnancy outcome during ovarian stimulation in vitro fertilization ultrasound Obstet Gynecol. 2001;18:258-63.

Fanchin R. Assessing uterine receptivity in 2001. Ultrasonographic glances at the New Millennium. An N Y Acad Sci. 2001;943:185-202.

Fleischer AC, Kepple DM, Vasquez J. Conventional and color Doppler transvaginal sonography in gynecologic infertility. Radiol Clin North Am. 1992;30:693-702.

Zhang X, Chen CH, Confino E, Barnes R, Milad M, Kazer RR. Increased endometrial thickness is associated with improved treatment outcome for selected patients undergoing in vitro fertilization-embryo transfer. Fertil Steril. 2005;2:336-40.

Ivanovski M, Lazarevski S, Popovik M, et al. Assessment of endometrial thickness and pattern in prediction of pregnancy in an in vitro fertilization an embryo transfer cycles after ovarian stimulation. Macedonian Medical Review. 2007;4-6:117-24.

Buckett WM. A Meta-analysis of ultrasound-guided versus clinical touch embryo transfer. Fertil Steril. 2003;80:1037-041.

Levi Setti PE, Albani E, Cavagna M, Bulletti C, Colombo GV, Negri L. The impact of embryo transfer on implantation – a review. Placenta. 2003;24(Suppl B):20-6

Woolcott R, Stanger J. Potentially important variables identified by transvaginal ultrasound-guided embryo transfer. Hum Reprod. 1997;12:963-6.

Sallam HN, Agameya AE, Rahman AF, Ezzeldin F, Sallam AN. Ultrasound measurement of the uterocervical angle before embryo transfer: a prospective controlled study. Hum Reprod. 2002;17:1767-72.

Goudas VT, Hammitt DG, Damario MA, Session DR, Singh AP, Dumesic DA. Blood on the embryo transfer catheter is associated with decreased rates of embryo implantation and clinical pregnancy with the use of in vitro fertilization-embryo transfer. Fertil Steril. 1998;70:878-82.

Lesny P, Killick SR. Tetlow RL, Manton DJ, Robinson J, Maguiness SD. Ultrasound evaluation of the uterine zonal anatomy during in vitro fertilization and embryo transfer. Hum Reprod. 1999;14:1593-8.

Pope CS, Cook EKD, Arny M, Novak A, Grow DR. Influence of embryo transfer depth on in vitro fertilization and embryo transfer outcomes. Fertil Steril. 2004;81:51-8.

Shamonki M, Schatman GL, Spandorfer SD, Rosenwaks Z. Ultrasound-guided embryo transfer may be beneficial in preparation for an IVF cycle. Hum Reprod. 2005;20(10):2844-9.

Dodson MG. Ovulation induction and transvaginal ultrasound. In:Transvaginal Ultrasound. New York: Churchill Livingstone. 1991;227-59.

Troiano RN, McCarthy SM. Mullerian duct anomalies: imaging and clinical issues. Radiology. 2004;233:19-34.

The American Fertility Society classification of adnexal adhesions, distal tubal occlusion, tubal occlusion secondary to tubal ligation, tubal pregnancies, mullerian anomalies and intrauterine adhesions. Fertil Steril. 1988;49:944-55.

Khati NJ, Fraizer AA, Brindle KA. The unicornuate uterus and its variants. J Ultrasound Med. 2012;31:319-31.

Taylor E, Gomel V. The uterus and fertility. Fertil Steril. 2008;89(1):1-16.

Pellerito JS, McCarthy SM, Doyle MB, Glickman MG, DeCherney AH. Diagnosis of Uterine anomalies: relative accuracy of MR Imaging, endovaginal sonography and hysterosalpingography, Radiology. 1992;183:795-800.

Homer HA, Li TC, Cokker ID. The Septate uterus: a review of management and reproductive outcome. Fertil Steril. 2000;73:1-14.

Tulandi T, Arronet GH, Mclnnes RA. Arcuate and bicornuate uterine anomalies and infertility. Fertile Steril. 1980;34:362-4.

Herbst AL, Senekjian EK, Frey KW. Abortion and Pregnancy loss among diethylstilbestrol-exposed women. Semin Endocrinol. 1989;7:124-9.

Riberio SC, Tormena RA, Peterson TV, et al. Mullerian duct anomalies: review of current management Sao Paulo Med J. 2009;127(2):92-6.

Choi HK, Cho KS, Lee KW, et al. MR Imaging of intersexuality. Radiographics. 1998;18:83-96.

Griffin Y, Sudigali V, Jacques A. Radiology of benign disorders of menstruation. Semin Ultrasound CT MR. 2010;116(3):747-58.

Thurmond AS. Imaging of female infertility. Radiol Clin North Am. 2003;41:757-67.

O’Neill M.J. Sonohysterography. Radiol Clin North Am. 2003:41:781-91.

Matalliotakis IM, Katsikis IK, Panidis DK. Adenomyosis: What is the impact on fertility? Curr Opin Obstet Gynecol. 2005;17:261-4.

Valentini AL, Gul SS, Sogali BG, et al. Adenomyosis from the sign of the diagnosis, imaging, diagnostic pitfall and differential diagnosis: a pictorial review. Radiol Med. 2011;116:1267-87.

Kunz G, Beil D, Huppert P, Noe M, Kissler S, Leyendecker G. Adenomyosis in endometriosis prevalence and impact on fertility. Evidence from magnetic resonance imaging. Hum Reprod. 2005;20:2309-316.

Deans R, Abborr J. Review of intrauterine adhesions. J Minim Invasive Gynecol. 2010;17(5):555-69.

Simpson WL, Beita LG, Mester J. Hysterosalpingography: a re-emerging study. Radiographics. 2006;26:419-31.

Valle RF, Sankpal R, Marlow JL, Cohen L. Cervical stenosis: a challenging clinical entity. J Gynecol Surg. 2002;18:129-43.

Sarto GE, Simpson JL. Abnormalities of the Mullerian and Wolffian duct systems. Birth Defects Orig Artic Ser. 1978;14:37-54.

Eng CW, Tang PH, Ong CL. Hysterosalpingography: Current applications. Singapore Med J. 2007;48(4):368-74.

Krysiewicz S. Infertility in women: diagnosis evaluation with hysterosalpingography and other imaging techniques. ARJ Am J Roentgenol. 1992;159:253-61.

Schankath AC, Fasching N, Urech-Ruh C, et al. Hysterosalpingography in the workup of female infertility: indications, technique, and diagnostic funding. Insights Imaging. 2012;3:475-83.

Kim MY, Rha SE, Oh SN. MR imaging findings of hydrosalpinx: a comprehensive review. Radiographics. 2009;29:495-507.

Chawla N, Kudesia S, Azad S, et al. Salpingitis isthmica nodosa. Indian J Pathol Microbiol. 2009;52:434-435.

Okeke TC, Ikeako LC, Ezenyeaku CCT. Endometriosis: a review article. Niger J Med. 2011;20(3):191-199.

Chamie LP, Blasbalg R, Pereira RM, et al. Findings of pelvic endometriosis at transvaginal US, MR imaging and laparoscopy. Radiographics. 2011;31:E77-100.