Advanced Imaging in Female Infertility
- 62 Downloads
Purpose of Review
This review highlights the role of imaging in the diagnosis and management of reproductive disorders. The additional information that imaging studies can contribute to reproductive medicine is emphasized, including the role of pelvic ultrasonography (US, including sonohysterography and contrast-enhanced hysterosalpingosonography), hysterosalpingography (HSG), and magnetic resonance imaging (MRI) of the female reproductive tract. In addition, the implications of congenital causes of infertility on the urinary tract in females are reviewed.
Recent Findings Summary
While the evaluation of infertility in women is initially focused on the assessment of ovulation via serum hormone levels, imaging plays a role in evaluating other causes of infertility. Recent research in this field focuses on the establishment of a comprehensive single imaging study for the assessment of female reproductive disorders. Two proposed methods are MR hysterosalpingography and Fertiliscan, a combination of high-quality 3D ultrasound and assessment of tubal patency with hysterosalpingo-foam-sonography, though more research is needed to determine the risks and benefits of each method, as well as their reliability.
KeywordsReproductive medicine Sonohysterography Contrast-enhanced hysterosalpingosonography Hysterosalpingography (HSG) Magnetic resonance imaging (MRI)
Compliance with Ethical Standards
Conflict of Interest
Carolyn F. Dishuck, Jordan D. Perchik, and Deidre D. Gunn each declare no potential conflicts of interest.
Kristin K. Porter is a section editor for Current Urology Reports.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
- 1.Zegers-Hochschild F, Adamson GD, de Mouzon J, Ishihara O, Mansour R, Nygren K, et al. International Committee for Monitoring Assisted Reproductive Technology (ICMART) and the World Health Organization (WHO) revised glossary of ART terminology, 2009. Fertil Steril. 2009;92(5):1520–4. https://doi.org/10.1016/j.fertnstert.2009.09.009.CrossRefGoogle Scholar
- 2.•• Infertility Workup for the Women’s Health Specialist: ACOG Committee Opinion, Number 781 (2019). Obstet Gynecol 133 (6):e377-e384. https://doi.org/10.1097/AOG.0000000000003271 Current recommendations of the American College of Obstetricians and Gynecologists (ACOG) and the American Society for Reproductive Medicine (ASRM) for the workup of infertility, including the role of imaging.
- 4.Mathews TJ, Hamilton BE. Mean age of mothers is on the rise: United States, 2000-2014. NCHS Data Brief. 2016;(232):1–8.Google Scholar
- 10.Ludwin A, Pityński K, Ludwin I, Banas T, Knafel A. Two- and three-dimensional ultrasonography and sonohysterography versus hysteroscopy with laparoscopy in the differential diagnosis of septate, bicornuate, and arcuate uteri. J Minim Invasive Gynecol. 2013;20(1):90–9. https://doi.org/10.1016/j.jmig.2012.09.011.CrossRefGoogle Scholar
- 14.• Levaillant J-M, Pasquier M, Massin N. A novel concept for female infertility exploration: the Fertiliscan©, a dedicated all-in-one 3D ultrasound exploration. J Gynecol Obstet Hum Reprod. 2019;48(5):363–7. https://doi.org/10.1016/j.jogoh.2019.01.008 Introduces an innovative comprehensive examination for evaluating female infertility with a combination of high quality 3D ultrasound and assessment of tubal patency with hysterosalpingo-foam-sonography. CrossRefGoogle Scholar
- 15.• Exacoustos C, Pizzo A, Lazzeri L, Pietropolli A, Piccione E, Zupi E. Three-dimensional hysterosalpingo contrast sonography with gel foam: methodology and feasibility to obtain 3-dimensional volumes of tubal shape. J Minim Invasive Gynecol. 2017;24(5):827–32. https://doi.org/10.1016/j.jmig.2017.04.007 Demonstrates that the novel hysterosalpingo-foam-sonography is a well-tolerated method for the evaluation of tubal course and patency. CrossRefPubMedGoogle Scholar
- 17.• Volondat M, Fontas E, Delotte J, Fatfouta I, Chevallier P, Chassang M. Magnetic resonance hysterosalpingography in diagnostic work-up of female infertility – comparison with conventional hysterosalpingography: a randomised study. EurRadiol. 2019;29(2):501–8. https://doi.org/10.1007/s00330-018-5572-2 Compares the diagnostic accuracy of MR-HSG with conventional radiographic HSG demonstrating comparable performance and reduced patient discomfort. CrossRefGoogle Scholar