Ultrasonography in assisted reproduction

Botros R. M. B. Rizk
In: Ultrasonography in Reproductive Medicine and Infertility · 2010 · pp. 193–250 · doi:10.1017/cbo9780511776854.026 · W2488722403
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

Adenomyosis, characterized by ectopic endometrial tissue in the myometrium, can be diagnosed using ultrasonography in conjunction with patient history and physical examination findings.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-07 ⓘ

This chapter reviews how ultrasonography is used in assisted reproduction, describing key reproductive anatomy visualization, ovarian reserve assessment, oocyte retrieval, and monitoring during IVF. It outlines that fallopian tubes are usually not seen, ovaries are identified by echogenic stroma and sonolucent follicles, ovarian reserve tests are used to gauge performance before controlled ovarian hyperstimulation, transvaginal ultrasound-guided aspiration is used for oocyte retrieval, and ultrasound is used to prevent/diagnose IVF complications such as ovarian hyperstimulation syndrome and multiple pregnancies. A limitation explicitly acknowledged is that visualization of specific structures (e.g., fimbrial end within fluid in the pouch of Douglas) is not always possible, and the chapter-level text does not provide quantitative performance metrics for these techniques. This paper does not explicitly discuss endometriosis or adenomyosis; it was included in the corpus via a keyword match in the upstream search index.

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Abstract

Clinically, adenomyosis is usually seen in women in their thirties but has been seen from the early twenties into the postmenopausal period. Pathologically, adenomyosis is confirmed if there are ectopic endometrial glands and stroma in the myometrium. This induces hyperplasia and hypertrophy of the adjacent smooth muscle, causing uterine enlargement. The sonographic diagnosis of fibroids has long been confused with that of adenomyosis. Leiomyomata or fibroids are common in women, with an increased incidence of 7 times in blacks and nulliparous women. In adenomyosis, the myometrium has areas of increased echogenicity that may be subtle and best appreciated with higher-resolution ultrasound scanners. The diagnosis of adenomyosis should not depend only on the sonographic appearance but must rather consider the whole picture or triad of history, sonographic features, and signs of tenderness. Adenomyosis has been suspected as cause of infertility. The treatment of adenomyosis is mainly symptomatic.

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adenomyosisinfertility

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