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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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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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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- Ultrasonography in Reproductive Medicine and Infertility - Ultrasonography in Reproductive Medicine and Infertility - Copyright page - Dedication - Contents - Contributors - Foreword - Preface - Acknowledgments - Section 1: Imaging techniques - Section 2: Ultrasonography in infertility - Section 3: Ultrasonography in assisted reproduction - Section 4: Early pregnancy after infertility treatment - Index Published online by Cambridge University Press: 07 September 2011 Edited by Book contents - Ultrasonography in Reproductive Medicine and Infertility - Ultrasonography in Reproductive Medicine and Infertility - Copyright page - Dedication - Contents - Contributors - Foreword - Preface - Acknowledgments - Section 1: Imaging techniques - Section 2: Ultrasonography in infertility - Section 3: Ultrasonography in assisted reproduction - Section 4: Early pregnancy after infertility treatment - Index Over the last 25 years, progress in the field of assisted reproduction has paralleled that in ultrasonography. Normal fallopian tubes are not usually seen by ultrasound, though it is sometimes possible to visualize the fimbrial end within fluid in the pouch of Douglas. The ovaries are usually seen lateral to the uterus, in close relationship to the internal iliac vessels. They can be identified by their echogenic stroma and sonolucent follicles. A variety of ovarian reserve tests are used in routine clinical practice to assess a woman's ovarian performance prior to controlled ovarian hyperstimulation (COH) for in vitro fertilization (IVF). Transvaginal ultrasound-guided aspiration of ovarian follicles provides a safe and effective means of oocyte retrieval. Embryo transfer is a crucial step of IVF treatment. Ultrasound is a cornerstone of prevention and diagnosis of potential IVF complications such as ovarian hyperstimulation syndrome (OHSS) and multiple pregnancies. - Type - Chapter - Information - Ultrasonography in Reproductive Medicine and Infertility , pp. 193 - 250Publisher: Cambridge University PressPrint publication year: 2010 Accessibility compliance for the HTML of this chapter is currently unknown and may be updated in the future. To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle. Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply. Find out more about the Kindle Personal Document Service. - Ultrasonography in assisted reproduction - Book: Ultrasonography in Reproductive Medicine and Infertility - Online publication: 07 September 2011 To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox. - Ultrasonography in assisted reproduction - Book: Ultrasonography in Reproductive Medicine and Infertility - Online publication: 07 September 2011 To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive. - Ultrasonography in assisted reproduction - Book: Ultrasonography in Reproductive Medicine and Infertility - Online publication: 07 September 2011

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adenomyosisinfertility

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