In vitro fertilization:

Cheng Toh Yeong, P.C. Wong
In: The Subfertility Handbook · 2010 · pp. 123–134 · doi:10.1017/cbo9780511919244.012 · W653974800
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⚙ AI-generated summary by claude@2026-06, 2026-06-10 ⓘ

Pelvic ultrasound is crucial for diagnosing infertility in women by assessing ovarian function, identifying ovulatory disorders like PCOS and POF, and detecting uterine and tubal pathologies.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-10 ⓘ

This chapter from The Subfertility Handbook reviews in vitro fertilization and other assisted reproductive techniques, discussing indications for IVF (including tubal infertility, endometriosis, ovarian dysfunction, surrogacy, and male factor) and describing the typical IVF cycle from ovarian stimulation and monitoring through trigger, oocyte retrieval, insemination/ICSI, embryo culture, embryo transfer, and luteal support. It notes that IVF indications have expanded with newer technologies such as ICSI, surgical sperm retrieval, embryo biopsy, and cryopreservation, and that IVF has become a cumulative step in the diagnosis and treatment of unexplained infertility. A major limitation is that the text is a clinician’s guide chapter rather than an empirical study, so it does not provide specific trial outcomes or evidence synthesis. Relevance to endometriosis: the chapter explicitly lists endometriosis among the indications for IVF, though its main focus is an overview of IVF indications and the standard IVF treatment workflow in subfertility.

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Abstract

The use of pelvic ultrasound to investigate the subfertile female needs a close collaboration between the gynecologist and the radiologist. Ultrasonography is now a must in the investigation of ovulation disorders, along with clinical findings and hormonal assays. It allows estimation of the ovarian function, mainly estrogen secretion, through measurement of the endometrial thickness: endometrial atrophy or severe hypotrophy (thickness more than 5 mm) indicates hypoestrogenism. It also contributes greatly to the diagnosis of ovulation disorders, in particular polycystic ovary syndrome (PCOS) and primary ovarian failure (POF), along with the clinical/biological data. The ultrasound is sensitive in detecting those lesions that are responsible for infertility through interference with egg migration and implantation and/or with sperm progression, such as fibroids, polyps, synechiae, or malformations. The 3D ultrasound can help in the diagnosis of uterine malformations. The majority of tubal obstructions are secondary to sexually transmitted infections, particularly gonorrhea and chlamydia.

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