Ultrasound Imaging of the Ovary in Infertility

Ovaries are oval soft tissue structures, seen as isoechoic stroma and anechoic follicles on ultrasound. Secondary antral follicles are follicles of 2–9 mm. One or two of these may attain dominance on approximately day 5 of the cycle. After dominance, it grows at the rate of 2–3 mm per day to reach a diameter of 18–24 mm. Perifollicular vascularity covering three-fourth of the follicular circumference with RI of ≤0.48 and PSV of ≥10 cm/s. Corpus luteum is the structure formed after rupture of the follicle and has thick isoechoic walls and hemorrhagic echogenecities. When functionally efficient, it shows pericorpus luteal flow with RI of ≤0.5. High resistance in the corpus luteal flow indicates corpus luteal insufficiency. Hyperechogenecity wall of the follicle with low level echoes and higher resistance than normal corpus luteum indicates luteinized unruptured follicle. Hemorrhagic cyst mimics corpus luteum on B mode but does not show flow on Doppler. Among the other common pathologies seen are Endometrioma which is identified by thick isoechoic walls with hyperechoic flecks, ground glass echogenicity, fluid-fluid level, pain on probe pressure, and adhesions. Dermoid has cystic and solid components, hairballs tooth like shadows with posterior shadowing, tip of the iceberg sign, hyperechoic lines, etc. Polycystic ovaries are identified by ovarian size of larger than 10 cc and more than 20 follicles per ovary with stromal abundance. Access this chapter Tax calculation will be finalised at checkout Purchases are for personal use only Similar content being viewed by others

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