ACR Appropriateness Criteria® Infertility

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The ACR Appropriateness Criteria provide evidence-based guidelines for selecting imaging modalities like transvaginal US, MRI, and HSG to evaluate various causes of infertility and recurrent pregnancy loss.

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Abstract

Appropriate imaging for women undergoing infertility workup depends upon the clinician's suspicion for potential causes of infertility. Transvaginal US is the preferred modality to assess the ovaries for features of polycystic ovary syndrome (PCOS), the leading cause of anovulatory infertility. For women who have a history or clinical suspicion of endometriosis, which affects at least one third of women with infertility, both MRI and pelvic US can provide valuable information. If tubal occlusion is suspected, whether due to endometriosis, previous pelvic inflammatory disease, or other cause, hysterosalpingogram (HSG) is the preferred method of evaluation. To assess for anatomic causes of recurrent pregnancy loss (RPL) such as Müllerian anomalies, synechiae, and leiomyomas, saline infusion sonohysterography, MRI and 3-D US are most appropriate. Up to 10% of women suffering recurrent pregnancy loss have a congenital Müllerian anomaly. When assessment of the pituitary gland is indicated, MRI is the imaging exam of choice.The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed every three years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances where evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment.

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Condition tags

endometriosisinfertility

MeSH descriptors

Diagnostic Imaging Endometriosis Fallopian Tube Diseases Infertility, Female Polycystic Ovary Syndrome Diagnostic Imaging Endometriosis Endometriosis Fallopian Tube Diseases Fallopian Tube Diseases Female Humans Infertility, Female Infertility, Female Polycystic Ovary Syndrome Polycystic Ovary Syndrome Practice Guidelines as Topic Pregnancy Radiology Radiology

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