Evaluating Infertility With Ultrasound Technology

Today the use of ultrasound for the evaluation and treatment of infertility is a routine practice and is considered an essential tool in the diagnosis and evaluation of ovulation and management of infertile couples.  It must be emphasized that ultrasound examination of the pelvic organs with the use of transvaginal probe is the common and standard way of using ultrasound in reproduction with the abdominal ultrasound used when a large pelvic or abdominal mass is present or during embryo transfer.  During vaginal ultrasound, the ultrasound probe which has been covered with a latex or non-latex sheath, will be lubricated with jelly and inserted slowly into the vagina and pointing anteriorly or posteriorly with slow movement of the probe from side to side to visualize the cervix, uterus, and ovaries.  The position of the uterus, presence or absence of pathologies like fibroids, the size of the uterus, the inner lining of the uterine cavity (endometrial lining), the size of the ovaries, presence or absence of any pathologies within the ovaries including cyst, mass, or endometriomas, and occasionally presence of fluid within the Fallopian tubes or in the posterior cul de sac can be evaluated.  In addition, ovaries can be evaluated sonographically and valuable information obtained regarding ovarian reserve from the number of small follicles visualized within the ovary. Transvaginal sonography is also used for monitoring of follicular development during ovulation induction, for diagnosis of ectopic pregnancy, and evaluation of early pregnancy loss.  Moreover, transvaginal sonogram is utilized during in vitro fertilization (IVF) for evaluation of follicular development and for oocyte retrieval eliminating any need for Laparoscopic egg retrieval.  Furthermore, color Doppler sonography has been used for evaluation of any changes in blood flow to the ovaries and to the endometrial lining during controlled ovarian hyperstimulation and follicular development. 

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