Vol 92, No 6 (2021)
Review paper
Published online: 2021-04-28

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A comprehensive use of ultrasound examination in infertility workup

Karolina Kowalczyk12, Dariusz Kowalczyk34, Mateusz Klimek5, Malgorzata Sateja6, Kamil Kowalczyk7, Grzegorz Franik12, Pawel Madej12
Pubmed: 33914311
Ginekol Pol 2021;92(6):453-459.

Abstract

Considering the growing availability of ultrasound diagnostic methods in gynecology, its role in the infertility setting is increasing. In this review, we present an up-to-date ultrasound based diagnostic scheme in infertility workup comprising the evaluation of ovarian anatomy and function, uterine exploration, as well as tubal patency. The possibility of performing the vast majority of infertility diagnostics by ultrasound in the ambulatory settings is not only attractive and beneficial to patients, but also to health care system. Thus, it is vital for gynecologists to implement modern non-invasive ultrasound modalities in their everyday practice.

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References

  1. Hrehorcak M, Nargund G. “One-Stop” fertility assessment using advanced ultrasound. Facts Views Vis Obgyn. 2011; 3(1): 8–12.
  2. Committee opinion no. 618: Ovarian reserve testing. Obstet Gynecol. 2015; 125(1): 268–273.
  3. Coelho Neto MA, Ludwin A, Borrell A, et al. Counting ovarian antral follicles by ultrasound: a practical guide. Ultrasound Obstet Gynecol. 2018; 51(1): 10–20.
  4. Re C, Mignini Renzini M, Rodriguez A, et al. From a circle to a sphere: the ultrasound imaging of ovarian follicle with 2D and 3D technology. Gynecol Endocrinol. 2019; 35(3): 184–189.
  5. Łukaszuk K, Kozioł K, Jakiel G, et al. Diagnostyka i leczenie niepłodności — rekomendacje Polskiego Towarzystwa Medycyny Rozrodu i Embriologii (PTMRiE) oraz Polskiego Towarzystwa Ginekologów i Położników (PTGP). Ginekol Perinatol Prakt. 2018; 3(3): 112–140.
  6. Iliodromiti S, Anderson RA, Nelson SM. Technical and performance characteristics of anti-Müllerian hormone and antral follicle count as biomarkers of ovarian response. Hum Reprod Update. 2015; 21(6): 698–710.
  7. Chan YY, Jayaprakasan K, Zamora J, et al. The prevalence of congenital uterine anomalies in unselected and high-risk populations: a systematic review. Hum Reprod Update. 2011; 17(6): 761–771.
  8. Ludwin A, Pityński K, Ludwin I, et al. Two- and three-dimensional ultrasonography and sonohysterography versus hysteroscopy with laparoscopy in the differential diagnosis of septate, bicornuate, and arcuate uteri. J Minim Invasive Gynecol. 2013; 20(1): 90–99.
  9. Grimbizis GF, Di Spiezio Sardo A, Saravelos SH, et al. The Thessaloniki ESHRE/ESGE consensus on diagnosis of female genital anomalies. Hum Reprod. 2016; 31(1): 2–7.
  10. Benacerraf B. Three-dimensional volume imaging in gynecology. Obstet Gynecol Clin North Am. 2019; 46(4): 755–781.
  11. Ni J, Han B, Liang J, et al. Three-dimensional 3D ultrasound combined with power Doppler for the differential diagnosis of endometrial lesions among infertile women. Int J Gynaecol Obstet. 2019; 145(2): 212–218.
  12. Technology assessment no. 12: sonohysterography. Obstet Gynecol. 2016; 128(2): e38–e42.
  13. Ludwin A, Martins WP, Ludwin I. Uterine cavity imaging, volume estimation and quantification of degree of deformity using automatic volume calculation: description of technique. Ultrasound Obstet Gynecol. 2017; 50(1): 138–140.
  14. Seshadri S, El-Toukhy T, Douiri A, et al. Diagnostic accuracy of saline infusion sonography in the evaluation of uterine cavity abnormalities prior to assisted reproductive techniques: a systematic review and meta-analyses. Hum Reprod Update. 2015; 21(2): 262–274.
  15. Anioł M, Dec G, Wojda K, et al. Usefulness of saline infusion sonohysterography and feeding artery imaging in endometrial polyp diagnosis. Ginekol Pol. 2017; 88(6): 285–288.
  16. Nieuwenhuis LL, Hermans FJr, Bij de Vaate AJ, et al. Three-dimensional saline infusion sonography compared to two-dimensional saline infusion sonography for the diagnosis of focal intracavitary lesions. Cochrane Database Syst Rev. 2017; 5(5): CD011126.
  17. Alalfy M, Osman OM, Salama S, et al. Evaluation of the cesarean scar niche in women with secondary infertility undergoing ICSI using 2D sonohysterography versus 3D sonohysterography and setting a standard criteria; alalfy simple rules for scar assessment by ultrasound to prevent health problems for women. Int J Womens Health. 2020; 12: 965–974.
  18. Antila-Långsjö R, Mäenpää JU, Huhtala H, et al. Comparison of transvaginal ultrasound and saline contrast sonohysterography in evaluation of cesarean scar defect: a prospective cohort study. Acta Obstet Gynecol Scand. 2018; 97(9): 1130–1136.
  19. Ludwin A, Ludwin I, Banas T, et al. Diagnostic accuracy of sonohysterography, hysterosalpingography and diagnostic hysteroscopy in diagnosis of arcuate, septate and bicornuate uterus. J Obstet Gynaecol Res. 2011; 37(3): 178–186.
  20. Zimmer M, Pomorski M, Kamiński P, et al. Polish Society of Gynecologists and Obstetricians Guidelines for the application of hysteroscopy in gynecology. Ginekol Pol. 2019; 90(8): 482–489.
  21. Emanuel MH, Exalto N. Hysterosalpingo-foam sonography (HyFoSy): a new technique to visualize tubal patency. Ultrasound Obstet Gynecol. 2011; 37(4): 498–499.
  22. Exalto N, Emanuel MH. Clinical aspects of HyFoSy as tubal patency test in subfertility workup. Biomed Res Int. 2019; 2019: 4827376.
  23. O'Flynn N. Assessment and treatment for people with fertility problems: NICE guideline. Br J Gen Pract. 2014; 64(618): 50–51.
  24. Strowitzki T. Gute Klinische Behandlung („Good clinical treatment“) bei Maßnahmen der assistierten Reproduktion (ART). Gynäkologische Endokrinologie. 2009; 7(1): 39–44.
  25. Engels V, Medina M, Antolín E, et al. Feasibility, tolerability, and safety of hysterosalpingo-foam sonography (hyfosy). multicenter, prospective Spanish study. J Gynecol Obstet Hum Reprod. 2021; 50(5): 102004.
  26. Mandia L, Personeni C, Antonazzo P, et al. Ultrasound in infertility setting: optimal strategy to evaluate the assessment of tubal patency. Biomed Res Int. 2017; 2017: 3205895.
  27. Ludwin I, Ludwin A, Wiechec M, et al. Accuracy of hysterosalpingo-foam sonography in comparison to hysterosalpingo-contrast sonography with air/saline and to laparoscopy with dye. Hum Reprod. 2017; 32(4): 758–769.
  28. Chen F, Quan J, Huang P, et al. Hysterosalpingo-contrast sonography with four-dimensional technique for screening fallopian tubal patency: let's make an exploration. J Minim Invasive Gynecol. 2017; 24(3): 407–414.
  29. Gao YB, Yan JH, Yang YD, et al. Diagnostic value of transvaginal four-dimensional hysterosalpingo-contrast sonography combined with recanalization in patients with tubal infertility. Niger J Clin Pract. 2019; 22(1): 46–50.
  30. Alcázar JL, Martinez A, Duarte M, et al. Two-dimensional hysterosalpingo-contrast-sonography compared to three/four-dimensional hysterosalpingo-contrast-sonography for the assessment of tubal occlusion in women with infertility/subfertility: a systematic review with meta-analysis. Hum Fertil (Camb). 2020 [Epub ahead of print]: 1–13.
  31. Thinkhamrop J, Laopaiboon M, Lumbiganon P. Prophylactic antibiotics for transcervical intrauterine procedures. Cochrane Database Syst Rev. 2007; 3: CD005637.
  32. Dreyer K, Out R, Hompes PGA, et al. Hysterosalpingo-foam sonography, a less painful procedure for tubal patency testing during fertility workup compared with (serial) hysterosalpingography: a randomized controlled trial. Fertil Steril. 2014; 102(3): 821–825.
  33. Karaman E, Çim N, Alkış İ, et al. Rectal indomethacin use in pain relief during hysterosalpingography: A randomized placebo controlled trial. J Obstet Gynaecol Res. 2016; 42(2): 195–201.
  34. Ludwin I, Martins WP, Nastri CO, et al. Pain intensity during ultrasound assessment of uterine cavity and tubal patency with and without painkillers: prospective observational study. J Minim Invasive Gynecol. 2017; 24(4): 599–608.
  35. Melcer Y, Nimrodi M, Levinsohn-Tavor O, et al. Analgesic efficacy of intrauterine lidocaine flushing in hysterosalpingo-foam sonography: a double-blind randomized controlled trial. J Minim Invasive Gynecol. 2020 [Epub ahead of print].
  36. Marci R, Marcucci I, Marcucci AA, et al. Hysterosalpingocontrast sonography (HyCoSy): evaluation of the pain perception, side effects and complications. BMC Med Imaging. 2013; 13: 28.
  37. Ludwin A, Ludwin I, Martins WP. Venous intravasation during evaluation of tubal patency by ultrasound contrast imaging. Ultrasound Obstet Gynecol. 2018; 51(1): 143–145.
  38. Ludwin A, Ludwin I, Szczeklik W, et al. Cutaneous small-vessel vasculitis following hysterosalpingo-foam sonography (HyFoSy). Ultrasound Obstet Gynecol. 2019; 54(6): 831–834.
  39. Drugs@FDA: FDA-Approved Drugs. https://www.accessdata.fda.gov/drugsatfda_docs/label/2020/125514s088lbl.pdf (2020-11-04).
  40. Tanaka K, Chua J, Cincotta R, et al. Hysterosalpingo-foam sonography (HyFoSy): Tolerability, safety and the occurrence of pregnancy post-procedure. Aust N Z J Obstet Gynaecol. 2018; 58(1): 114–118.
  41. Wang R, van Welie N, van Rijswijk J, et al. Effectiveness on fertility outcome of tubal flushing with different contrast media: systematic review and network meta-analysis. Ultrasound Obstet Gynecol. 2019; 54(2): 172–181.
  42. Zen M, Kirby A, Dowthwaite S, et al. Lipiodol visibility under ultrasound. Aust N Z J Obstet Gynaecol. 2020; 60(4): 598–604.
  43. van Rijswijk J, van Welie N, Dreyer K, et al. The FOAM study: is Hysterosalpingo foam sonography (HyFoSy) a cost-effective alternative for hysterosalpingography (HSG) in assessing tubal patency in subfertile women? Study protocol for a randomized controlled trial. BMC Womens Health. 2018; 18(1): 64.
  44. Levaillant JM, Pasquier M, Massin N. A novel concept for female infertility exploration: the Fertiliscan©, a dedicated all-in-one 3D ultrasound exploration. J Gynecol Obstet Hum Reprod. 2019; 48(5): 363–367.