Ultrasound Assessment of the Ovary in the Infertile Woman

ABSTRACT

Few would argue that the introduction of transvaginal ultrasound (TVUS) revolutionized the practice of assisted reproduction. For example, full-bladder follicular scanning and laparoscopic oocyte retrievals were converted to TVUS-guided procedures. The application of higher-frequency scanning probes provided greater resolution and improved the clinician's ability to evaluate the ovary for pathologic conditions, for determination of ovarian reserve, and for therapeutic decisions during ovarian stimulation cycles. All these uses of TVUS of the ovary will be discussed in this article.

KEYWORDS

Ultrasound - ovary - infertility - ovarian reserve - IVF

REFERENCES

• 1 Pavlik E J, DePriest P D, Gallion H H et al.. Ovarian volume related to age.  Gynecol Oncol. 2000;  77 410-412
• 2 Syrop C H, Willhoite A, Van Voorhis B J. Ovarian volume: a novel outcome predictor for assisted reproduction.  Fertil Steril. 1995;  64 1167-1171
• 3 Syrop C H, Dawson J D, Husman K J, Sparks A ET, Van Voorhis B J. Ovarian volume may predict assisted reproductive outcomes better than follicle stimulating hormone concentration on day 3.  Hum Reprod. 1999;  14 1752-1756
• 4 Hendriks D J, Kwee J, Mol B WJ, te Velde E R, Broekmans F JM. Ultrasonography as a tool for the prediction of outcome in IVF patients: a comparative meta-analysis of ovarian volume and antral follicle count.  Fertil Steril. 2007;  87 764-775
• 5 Ruess M L, Kline J, Santos R, Levin B, Timor-Tritsch I. Age and the ovarian follicle pool assessed with transvaginal ultrasonography.  Am J Obstet Gynecol. 1996;  174 624-627
• 6 Scheffer G J, Broekmans F JM, Dorland M, Habbema J DF, Looman C WN, te Velde E R. Antral follicle counts by transvaginal ultrasonography are related to age in women with proven natural fertility.  Fertil Steril. 1999;  72 845-851
• 7 Tomas C, Nuojua-Huttunen S, Martikainen H. Pretreatment transvaginal ultrasound examination predicts ovarian responsiveness to gonadotrophins in in-vitro fertilization.  Hum Reprod. 1997;  12 220-223
• 8 Frattarelli J L, Lauria-Costa D F, Miller B T, Bergh P A, Scott R T. Basal antral follicle number and mean ovarian diameter predict cycle cancellation and ovarian responsiveness in assisted reproductive technology cycles.  Fertil Steril. 2000;  74 512-517
• 9 Bancsi L FJMM, Broekmans F JM, Eijkemans M JC, de Jong F H, Habbema J DF, te Velde E R. Predictors of poor ovarian response in in vitro fertilization: a prospective study comparing basal markers of ovarian reserve.  Fertil Steril. 2002;  77 328-336
• 10 Hendriks D J, Mol B-WJ, Bancsi L FHMM, te Velde E R, Broekmans F JM. Antral follicle count in the prediction of poor ovarian response and pregnancy after in vitro fertilization: a meta-analysis and comparison with basal follicle-stimulating hormone level.  Fertil Steril. 2005;  83 291-301
• 11 Sharara F I, McClamrock H D. Use of microdose GnRH agonist protocol in women with low ovarian volumes undergoing IVF.  Hum Reprod. 2001;  16 500-503
• 12 Hammadieh N, Afnan M, Papaaioannou S, Ola B. Women with small ovarian volume and microdose GnRH agonist protocol [Letter to editor].  Hum Reprod. 2001;  16 2030
• 13 Danninger B, Brunner M, Obruca A, Feichtinger W. Prediction of ovarian hyperstimulation syndrome of baseline ovarian volume prior to stimulation.  Hum Reprod. 1996;  11 1597-1599
• 14 Balen A H, Laven J SE, Tan S-L, Dewailly D. Ultrasound assessment of the polycystic ovary: international consensus definitions.  Hum Reprod Update. 2003;  9 505-514
• 15 Jonard S, Robert Y, Cortet-Rudelli C, Pigny P, Decanter C, Dewailly D. Ultrasound examination of polycystic ovaries: is it worth counting the follicles?.  Hum Reprod. 2003;  18 598-603
• 16 Gupta S, Agrwal A, Agarwal R, de Mola J RL. Impact of ovarian endometrioma on assisted reproduction outcomes.  Reprod Biomed Online. 2006;  13 349-360
• 17 Santoro N, Isaac B, Neal-Perry G et al.. Impaired folliculogenesis and ovulation in older reproductive aged women.  J Clin Endocrinol Metab. 2003;  88 5502-5509
• 18 Wittmaack F M, Tureck R W, Kreger D O, Mastrioanni L, Blasco L, Lessey B A. Effect of follicular size on oocyte retrieval, fertilization, cleavage, and embryo quality in in vitro fertilization cycles: a 6-year data collection.  Fertil Steril. 1994;  62 1205-1210
• 19 Andersen C Y. Characteristics of human follicular fluid associated with successful conception after in vitro fertilization.  J Clin Endocrinol Metab. 1993;  77 1227-1234
• 20 Bergh C, Broden H, Lundin K, Hamberger L. Comparison of fertilization, cleavage and pregnancy rates of oocytes from large and small follicles.  Hum Reprod. 1998;  13 1912-1915
• 21 Lewis V, Queenan J, Hoeger K, Stevens J, Guzick D S. Clomiphene citrate monitoring for intrauterine insemination timing: a randomized trial.  Fertil Steril. 2006;  85 401-406
• 22 Jokubkiene L, Sladkevicius P, Rovas L, Valentin L. Assessment of changes in volume and vascularity of the ovaries during the normal menstrual cycle using three-dimensional power Doppler ultrasound.  Hum Reprod. 2006;  21 2661-2668
• 23 Bhal P S, Pugh N D, Chui D K, Gregory L, Walker S M, Shaw R W. The use of transvaginal power Doppler ultrasonography to evaluate the relationship between perifollicular vascularity and outcome in in-vitro fertilization treatment cycles.  Hum Reprod. 1999;  14 939-945
• 24 Campbell S, Bourse T, Waterstone J et al.. Transvaginal color blood flow imaging of the peri ovulatory follicle.  Fertil Steril. 1993;  60 433-438
• 25 Costello M F, Shrestha S M, Sjoblom P et al.. Power Doppler ultrasound assessment of the relationship between age and ovarian perifollicular blood flow in women undergoing in-vitro fertilization treatment.  J Assist Reprod Genet. 2006;  23 359-365
• 26 Palomba S, Russo T, Falbo A et al.. Clinical use of the perifollicular vascularity assessment in IVF cycles: a pilot study.  Hum Reprod. 2006;  21 1055-1061