Ultrasound Assessment of the Ovary in the Infertile Woman

 

 Buy Article Permissions and Reprints

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.

REFERENCES

• 1 Pavlik E J, DePriest P D, Gallion H H et al.. Ovarian volume related to age.  Gynecol Oncol. 2000;  77 410-412
  CrossrefPubMedGoogle Scholar
• 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
  PubMedGoogle Scholar
• 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
  CrossrefPubMedGoogle Scholar
• 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
  CrossrefPubMedGoogle Scholar
• 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
  PubMedGoogle Scholar
• 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
  CrossrefPubMedGoogle Scholar
• 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
  CrossrefPubMedGoogle Scholar
• 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
  CrossrefPubMedGoogle Scholar
• 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
  CrossrefPubMedGoogle Scholar
• 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
  CrossrefPubMedGoogle Scholar
• 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
  CrossrefPubMedGoogle Scholar
• 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
  CrossrefPubMedGoogle Scholar
• 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
  PubMedGoogle Scholar
• 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
  CrossrefPubMedGoogle Scholar
• 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
  CrossrefPubMedGoogle Scholar
• 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
  CrossrefPubMedGoogle Scholar
• 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
  CrossrefPubMedGoogle Scholar
• 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
  PubMedGoogle Scholar
• 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
  CrossrefPubMedGoogle Scholar
• 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
  CrossrefPubMedGoogle Scholar
• 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
  CrossrefPubMedGoogle Scholar
• 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
  CrossrefPubMedGoogle Scholar
• 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
  CrossrefPubMedGoogle Scholar
• 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
  PubMedGoogle Scholar
• 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
  PubMedGoogle Scholar
• 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
  PubMedGoogle Scholar

Bradley J Van VoorhisM.D. 

Department of Obstetrics & Gynecology, University of Iowa Hospitals

200 Hawkins Drive, Iowa City, IA 52242

Email: brad-van-voorhis@uiowa.edu