Advertisement

Reproduktionsmedizin

  • Christoph Brezinka
  • Dietmar Spitzer
Chapter

Zusammenfassung

Ultraschall in der Reproduktionsmedizin hat eine klare Zielsetzung: man will mit der Ultraschalltechnik so viel wie möglich über die Chancen der Frau, erfolgreich schwanger zu werden, herausbekommen. Damit ist der Ultraschall eine Technik, die die Frau mit Kinderwunsch auf Schritt und Tritt begleitet – wobei eine möglichst umfassende Ultraschalluntersuchung am Anfang einer jeden Abklärung stehen sollte. Zu dieser Basisuntersuchung, dem „fertility scan“, gehört die Beurteilung des Uterus, des Endometriums, der Ovarien mit ihren Follikeln, der Durchblutung von Uterus und Ovarien und die Hysterokontrastsonografie (HyCoSy) zur Beurteilung der Tubendurchgängigkeit.

Literatur

  1. Ayida G, Harris P, Kennedy S, Seif M, Barlow D, Chamberlain P (1996) Hysterosalpingo-contrast sonography (HyCoSy) using Echovist-200 in the outpatient investigation of infertility patients. Br J Radiol 69:910–913CrossRefPubMedCentralGoogle Scholar
  2. Baerwald AR, Walker RA, Pierson RA (2009) Growth rates of ovarian follicles during natural menstrual cycles, oral contraception cycles, and ovarian stimulation cycles. Fertil Steril 91:440–449CrossRefPubMedCentralGoogle Scholar
  3. Bagtharia S, Haloob AR (2005) Is there a benefit from routine follicular flushing for oocyte retrieval? J Obstet Gynaecol 25:374–376CrossRefPubMedCentralGoogle Scholar
  4. Barton SE, Politch JA, Benson CB, Ginsburg ES, Gargiulo AR (2011) Transabdominal follicular aspiration for oocyte retrieval in patients with ovaries inaccessible by transvaginal ultrasound. Fertil Steril 95:1773–1776CrossRefPubMedCentralGoogle Scholar
  5. Choi DH, Kwon H, Kim YS, Kim JH (2009) Intramural pregnancy associated with adenomyosis after in vitro fertilization and embryo transfer: a case report. J Reprod Med 54:255–258PubMedPubMedCentralGoogle Scholar
  6. Dal J, Vural B, Caliskan E, Ozkan S, Yucesoy I (2005) Power Doppler ultrasound studies of ovarian, uterine, and endometrial blood flow in regularly menstruating women with respect to luteal phase defects. Fertil Steril 84:224–227CrossRefPubMedCentralGoogle Scholar
  7. Duijkers IJ, Klipping C (2010) Polycystic ovaries, as defined by the 2003 Rotterdam consensus criteria, are found to be very common in young healthy women. Gynecol Endocrinol 26:152–160CrossRefPubMedCentralGoogle Scholar
  8. Exacoustos C, Brienza L, Di GA, Szabolcs B, Romanini ME, Zupi E, Arduini D (2011) Adenomyosis: three-dimensional sonographic findings of the junctional zone and correlation with histology. Ultrasound Obstet Gynecol 37:471–479CrossRefPubMedCentralGoogle Scholar
  9. Exacoustos C, Zupi E, Szabolcs B, Amoroso C, Di GA, Romanini ME, Arduini D (2009) Contrast-tuned imaging and second-generation contrast agent SonoVue: a new ultrasound approach to evaluation of tubal patency. J Minim Invasive Gynecol 16:437–444CrossRefPubMedCentralGoogle Scholar
  10. Gembruch U, Diedrich K, Welker B, Wahode J, van der Ven H, Al-Hasani S, Krebs D (1988) Transvaginal sonographically guided oocyte retrieval for in-vitro fertilization. Hum Reprod 3(Suppl 2):59–63CrossRefPubMedCentralGoogle Scholar
  11. Goldstein SR (2007) Postmenopausal endometrial fluid collections revisited: look at the doughnut rather than the hole. Obstet Gynecol 83:738–740Google Scholar
  12. Hrehorcak M, Nargund G (2011) „One Stop“ fertility assessment using advanced ultrasound technology, Facts, Views and Visions. ObGyn 3:8–14Google Scholar
  13. Jervälä IY, Ruokonen A, Tekay A (2008) Effect of rising hCG levels on the human corpus luteum during early pregnancy. Hum Reprod 23:2775–2781CrossRefGoogle Scholar
  14. Jokubkiene L, Sladkevicius P, Rovas L, Valentin L (2006) Assessment of changes in endometrial and subendometrial volume and vascularity during the normal menstrual cycle using three-dimensional power Doppler ultrasound. Ultrasound Obstet Gynecol 27:672–679CrossRefPubMedCentralGoogle Scholar
  15. Jurkovic D, Valentin L, Vyas S (2009) Gynecological Ultrasound in Clinical Practice – Ultrasound imaging in the management of gynaecological conditions. RCOG Press, LondonCrossRefGoogle Scholar
  16. Kelly SM, Sladkevicius P, Campbell S, Nargund G (2001) Investigation of the infertile couple: a one-stop ultrasound-based approach. Hum Reprod 16:2481–2484CrossRefPubMedCentralGoogle Scholar
  17. Kristensen SL, Ramlau-Hansen CH, Ernst E, Olsen SF, Bonde JP, Vested A, Toft G (2010) A very large proportion of young Danish women have polycystic ovaries: is a revision of the Rotterdam criteria needed? Hum Reprod 25:3117–3122CrossRefPubMedCentralGoogle Scholar
  18. Kwan I, Bhattacharya S, McNeil A, van Rumste MM (2008) Monitoring of stimulated cycles in assisted reproduction (IVF and ICSI), Cochrane. Database. Syst. Rev. CD005289Google Scholar
  19. Lass A (2003) Monitoring of in vitro fertilization-embryo transfer cycles by ultrasound versus by ultrasound and hormonal levels: a prospective, multicenter, randomized study. Fertil Steril 80:80–85CrossRefPubMedCentralGoogle Scholar
  20. Lieng M, Istre O, Qvigstad E (2010) Treatment of endometrial polyps: a systematic review. Acta Obstet Gynecol Scand 89:992–1002CrossRefPubMedCentralGoogle Scholar
  21. Ludwig AK, Glawatz M, Griesinger G, Diedrich K, Ludwig M (2006) Perioperative and post-operative complications of transvaginal ultrasound-guided oocyte retrieval: prospective study of >1000 oocyte retrievals. Hum Reprod 21:3235–3240CrossRefPubMedCentralGoogle Scholar
  22. Mains L, Van Voorhis BJ (2010) Optimizing the technique of embryo transfer. Fertil Steril 94:785–790CrossRefPubMedCentralGoogle Scholar
  23. Merce LT, Garces D, Barco MJ, de la Fuente F (1992) Intraovarian Doppler velocimetry in ovulatory, dysovulatory and anovulatory cycles. Ultrasound Obstet Gynecol 2:197–202CrossRefPubMedCentralGoogle Scholar
  24. Miyazaki T, Tanaka M, Miyakoshi K, Minegishi K, Kasai K, Yoshimura Y (1998) Power and colour Doppler ultrasonography for the evaluation of the vasculature of the human corpus luteum. Hum Reprod 13:2836–2841CrossRefPubMedCentralGoogle Scholar
  25. Murtinger M, Aburumieh A, Rubner P, Eichel V, Zech MH, Zech NH (2009) Improved monitoring of ovarian stimulation using 3D transvaginal ultrasound plus automated volume count. Reprod Biomed Online 19:695–699CrossRefPubMedCentralGoogle Scholar
  26. Pache TD, Wladimiroff JW, de Jong FH, Hop WC, Fauser BC (1990) Growth patterns of nondominant ovarian follicles during the normal menstrual cycle. Fertil Steril 54:638–642CrossRefPubMedCentralGoogle Scholar
  27. Pavone ME, Hirshfeld-Cytron JE, Kazer RR (2011) The progressive simplification of the infertility evaluation. Obstet Gynecol Surv 66:31–41CrossRefPubMedCentralGoogle Scholar
  28. Porat N, Boehnlein LM, Schouweiler CM, Kang J, Lindheim SR (2010) Interim analysis of a randomized clinical trial comparing abdominal versus transvaginal ultrasound-guided embryo transfer. J Obstet Gynaecol Res 36:384–392CrossRefPubMedCentralGoogle Scholar
  29. Pritts EA, Parker WH, Olive DL (2009) Fibroids and infertility: an updated systematic review of the evidence. Fertil Steril 91:1215–1223CrossRefPubMedCentralGoogle Scholar
  30. Qublan H, Amarin Z, Nawasreh M, Diab F, Malkawi S, Al-Ahmad N, Balawneh M (2006) Luteinized unruptured follicle syndrome: incidence and recurrence rate in infertile women with unexplained infertility undergoing intrauterine insemination. Hum Reprod 21:2110–2113CrossRefPubMedCentralGoogle Scholar
  31. Raine-Fenning N, Jayaprakasan K, Clewes J, Joergner I, Bonaki SD, Chamberlain S, Devlin L, Priddle H, Johnson I (2008) SonoAVC: a novel method of automatic volume calculation. Ultrasound Obstet Gynecol 31:691–696CrossRefPubMedCentralGoogle Scholar
  32. Roche M, Ibarrola M, Lamberto N, Larranaga C, Garcia MA (2008) Spontaneous hemoperitoneum in a twin pregnancy complicated by endometriosis. J Matern Fetal Neonatal Med 21:924–926CrossRefPubMedCentralGoogle Scholar
  33. Romer Z, Schwesinger G, Foth D (2001) Endometrial sarcoidosis manifesting as recurrent serometra in a postmenopausal woman. Acta Obstet Gynecol Scand 80:482–483CrossRefPubMedCentralGoogle Scholar
  34. Sladkevicius P, Ojha K, Campbell S, Nargund G (2000) Three-dimensional power Doppler imaging in the assessment of Fallopian tube patency. Ultrasound Obstet Gynecol 16:644–647CrossRefPubMedCentralGoogle Scholar
  35. Sladkevicius P, Valentin L, Marsal K (1993) Blood flow velocity in the uterine and ovarian arteries during the normal menstrual cycle. Ultrasound Obstet Gynecol 3:199–208CrossRefPubMedCentralGoogle Scholar
  36. Tamura H, Takasaki A, Taniguchi K, Matsuoka A, Shimamura K, Sugino N (2008) Changes in blood-flow impedance of the human corpus luteum throughout the luteal phase and during early pregnancy. Fertil Steril 90:2334–2339CrossRefPubMedCentralGoogle Scholar
  37. The Practice Committee of the American Society for Reproductive Medicine (2008) Ovarian hyperstimulation syndrome. Fertil Steril 90:188–193Google Scholar
  38. Tinkanen H, Kujansuu E, Laippala P (1995) The association between hormone levels and vascular resistance in uterine and ovarian arteries in spontaneous menstrual cycles – a Doppler ultrasound study. Acta Obstet Gynecol Scand 74:297–301CrossRefPubMedCentralGoogle Scholar
  39. Van den Bosch T, Van SD, Domali E, Vergote I, Moerman P, Amant F, Timmerman D (2007) A thin and regular endometrium on ultrasound is very unlikely in patients with endometrial malignancy. Ultrasound Obstet Gynecol 29:674–679CrossRefPubMedCentralGoogle Scholar
  40. Villarroel C, Merino PM, Lopez P, Eyzaguirre FC, Van VA, Iniguez G, Codner E (2011) Polycystic ovarian morphology in adolescents with regular menstrual cycles is associated with elevated anti-Mullerian hormone. Hum Reprod 26(10):2861–2868CrossRefPubMedCentralGoogle Scholar
  41. Yanaihara A, Yorimitsu T, Motoyama H, Iwasaki S, Kawamura T (2008) Location of endometrial polyp and pregnancy rate in infertility patients. Fertil Steril 90:180–182CrossRefPubMedCentralGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Christoph Brezinka
    • 1
  • Dietmar Spitzer
    • 2
  1. 1.Department für FrauenheilkundeUniversitätsklinik für Gynäkologische Endokrinologie und ReproduktionsmedizinInnsbruckÖsterreich
  2. 2.IvF Zentren Prof. ZechSalzburg GmbHSalzburgÖsterreich

Personalised recommendations