Ultrasound imaging in human reproduction: what is new?

Abstract

Three-dimensional (3D) ultrasound seems to be advantageous in patients scheduled for serial ovarian monitoring, in whom planar reformatted sections allow more accurate and objective volumetric assessment of the leading follicles, which are not always spherical. Ovarian volume measurements by 3D ultrasound may contribute to accurate diagnosis of polycystic ovarian syndrome, prediction of the response to stimulation and estimation of the risk of ovarian hyperstimulation. Transvaginal ultrasound-directed follicular aspiration and embryo transfer under 3D ultrasound guidance improves the operator's spatial evaluation and allows precise follicular and/or catheter tip location during the course of interventional procedures. The use of 3D transvaginal ultrasonography after injection of saline solution and/or echo enhancing contrast medium produces high diagnostic accuracy for visualization of the uterine cavity and fallopian tubes. By providing multiple tomographic sections of the uterine cavity, uterine causes of infertility such as congenital uterine anomalies, submucous leiomyoma and/or intrauterine adhesions become easily visible. Quantification of the endometrial volume by 3D ultrasound, in combination with blood flow studies, contributes to the assessment of endometrial receptivity and has a potential to predict pregnancy rates in assisted reproductive techniques.