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Sonographische Diagnostik bei Kinderwunsch

Relevante Befunde und therapeutische Optionen

Ultrasound assessment in infertility

Relevant diagnoses and therapeutic options

  • Leitthema
  • Published:
Der Gynäkologe Aims and scope

Zusammenfassung

Eine detaillierte sonographische Untersuchung im Rahmen der Sterilitätsdiagnostik ermöglicht es inzwischen, eine Vielzahl an Informationen hinsichtlich der morphologischen Integrität der gynäkologischen Organe bereits im Zuge der Erstvorstellung abzurufen. Mittels hochauflösender Transvaginalsonden können so in der konventionellen 2‑D- bzw. in der gezielten 3‑D-Volumensongraphie zwischen Zyklustag 5 und 9 fertilitätsrelevante Befunde wie das Vorhandensein von Müllerganganomalien, Auffälligkeiten des Endometriums bzw. der endometrialen-myometrialen Grenzschicht, des Uteruskavums, die Lokalisation von Leiomyomen oder eine Adenomyosis diagnostiziert werden. Im gleichen Setting ist es möglich, die Tubendurchgängigkeit (Hysterosalpingokontrastsonographie, HyCoSy) zu prüfen und die ovarielle Reserve durch einen antralen Follikelcount (AFC) abzuschätzen. Damit kann Frauen prinzipiell eine auf einen einzelnen Termin kondensierte, zeit- wie kosteneffiziente und dennoch ausführliche und in der Regel ambulant durchzuführende apparative Sterilitätsabklärung angeboten werden.

Abstract

A comprehensive ultrasound evaluation during infertility work-up can provide detailed information regarding the morphology of the pelvic organs already during the first examination. Using high-frequency probes for conventional 2D ultrasound or 3D volumetry between cycle day 5 and 9, it is possible to rule out Mullerian duct anomalies, endometrial lesions, disruptions of the endometrial–myometrial junction, anomalies of the uterine cavity, leiomyomas and adenomyosis. In the same setting, it is possible to check for tubal patency (hysterosalpingo contrast sonography, HyCoSy) and to assess the ovarian reserve by means of an antral follicle count (AFC). All patients can obtain a reliable time and cost efficient infertility evaluation during a single outpatient visit.

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Authors and Affiliations

  1. Bereich Pränatalmedizin und Spezielle Geburtshilfe, Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Deutschland

    J. Weichert, M. Gembicki, A. Rody & D. Hartge

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Correspondence to J. Weichert.

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J. Weichert, M. Gembicki, A. Rody und D. Hartge geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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A. Schröer, Berlin

B.-J. Hackelöer, Hamburg

J. Weichert, Lübeck

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Weichert, J., Gembicki, M., Rody, A. et al. Sonographische Diagnostik bei Kinderwunsch. Gynäkologe 51, 188–196 (2018). https://doi.org/10.1007/s00129-018-4201-0

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