ULTRASONOGRAPHY IN ASSISTED REPRODUCTION

Can we imagine ART today without imaging? Ultrasound has become the most widely used and important tool in the diagnosis and treatment of infertility. When a patient presents with infertility, ultrasound evaluation is the key part of the exam performed to evaluate the ovaries, uterus, and fallopian tubes. The saline sonogram is used most commonly as an evaluation of the uterine cavity before ART and can identify both congenital and acquired anomalies as well as tubal patency and the presence of hydrosalpinges. This initial ultrasound exam of the ovaries includes an antral follicle count (AFC) for ovarian reserve, diagnosis of polycystic appearing ovaries, endometriosis, and other adnexal pathologies. When ART treatment begins, ultrasound is used for monitoring of follicular development and endometrial response and is critical in the success of the cycle. Ultrasound guided procedures for oocyte retrieval and embryo transfer (ET) are standard practice and ultrasound guidance is helpful in the treatment of Asherman’s syndrome and congenital anomalies such as a large septate uterus. Of course, the goal of ART is a singleton viable pregnancy, and early ultrasound monitoring can evaluate the location and viability of the pregnancy and the existence of multiples or vanishing twins.