Onm-1: Imaging in Female Infertility

The role of imaging in female infertility has undergone a revolution over the past few decades .Sonography plays an integral role in the evaluation of gynecologic disease. It can determine the organ or site of abnormality and provide a diagnosis or short differential in the vast majority of patients. Both the transabdominal and transvaginal approaches are now well –established techniques for assessing the female pelvic organs. Transvaginal sonography is now considered an essential part of almost all pelvic ultrasound examinations. Color and spectral Doppler sonography have evolved to play a role in assessing normal and pathologic blood flow.Doppler can also distinguish vascular structures from nonvascular structures, such as dilated fallopian tubes or fluid-filled bowel loops. The more recent addition of Hysterosonography (SHG) has provided more detailed evaluation of the endometrium,allowing differentiation among intracavitary, endometrial, and submucosal lesions. Threedimensional (3D) ultrasound also plays an important role in the diagnosis of congenital uterine anomalies and endometrial volume measurements. Sonography also plays an important role in guiding interventional procedures such as magnetic resonance imaging (MRI) . MRI because of excellent tissue characterization, can occasionally be helpful when sonography is inconclusive and in the staging of pelvic malignancies. Computed tomography (CT) has a limited role but is used for cancer staging.Hysterosalpingography (HSG) is the radiographic evaluation of the cavity of the uterus and fallopian tube and as a commonly performed examination plays an important role in reproductive medicine.