Skip to main content
Log in

Advanced Imaging in Female Infertility

  • New Imaging Techniques (S Rais-Bahrami and K Porter, Section Editors)
  • Published:
Current Urology Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

This review highlights the role of imaging in the diagnosis and management of reproductive disorders. The additional information that imaging studies can contribute to reproductive medicine is emphasized, including the role of pelvic ultrasonography (US, including sonohysterography and contrast-enhanced hysterosalpingosonography), hysterosalpingography (HSG), and magnetic resonance imaging (MRI) of the female reproductive tract. In addition, the implications of congenital causes of infertility on the urinary tract in females are reviewed.

Recent Findings Summary

While the evaluation of infertility in women is initially focused on the assessment of ovulation via serum hormone levels, imaging plays a role in evaluating other causes of infertility. Recent research in this field focuses on the establishment of a comprehensive single imaging study for the assessment of female reproductive disorders. Two proposed methods are MR hysterosalpingography and Fertiliscan, a combination of high-quality 3D ultrasound and assessment of tubal patency with hysterosalpingo-foam-sonography, though more research is needed to determine the risks and benefits of each method, as well as their reliability.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Zegers-Hochschild F, Adamson GD, de Mouzon J, Ishihara O, Mansour R, Nygren K, et al. International Committee for Monitoring Assisted Reproductive Technology (ICMART) and the World Health Organization (WHO) revised glossary of ART terminology, 2009. Fertil Steril. 2009;92(5):1520–4. https://doi.org/10.1016/j.fertnstert.2009.09.009.

    Article  CAS  Google Scholar 

  2. •• Infertility Workup for the Women’s Health Specialist: ACOG Committee Opinion, Number 781 (2019). Obstet Gynecol 133 (6):e377-e384. https://doi.org/10.1097/AOG.0000000000003271 Current recommendations of the American College of Obstetricians and Gynecologists (ACOG) and the American Society for Reproductive Medicine (ASRM) for the workup of infertility, including the role of imaging.

  3. Vander Borght M, Wyns C. Fertility and infertility: definition and epidemiology. Clin Biochem. 2018;62:2–10. https://doi.org/10.1016/j.clinbiochem.2018.03.012.

    Article  PubMed  Google Scholar 

  4. Mathews TJ, Hamilton BE. Mean age of mothers is on the rise: United States, 2000-2014. NCHS Data Brief. 2016;(232):1–8.

  5. Mittal PK, Little B, Harri PA, Miller FH, Alexander LF, Kalb B, et al. Role of imaging in the evaluation of male infertility. RadioGraphics. 2017;37(3):837–54. https://doi.org/10.1148/rg.2017160125.

    Article  Google Scholar 

  6. Vickramarajah S, Stewart V, van Ree K, Hemingway AP, Crofton ME, Bharwani N. Subfertility: what the radiologist needs to know. RadioGraphics. 2017;37(5):1587–602. https://doi.org/10.1148/rg.2017170053.

    Article  PubMed  Google Scholar 

  7. Gnoth C, Godehardt E, Frank-Herrmann P, Friol K, Tigges J, Freundl G. Definition and prevalence of subfertility and infertility. Hum Reprod. 2005;20(5):1144–7. https://doi.org/10.1093/humrep/deh870.

    Article  CAS  PubMed  Google Scholar 

  8. Practice Committee of the American Society for Reproductive M. Diagnostic evaluation of the infertile female: a committee opinion. Fertil Steril. 2015;103(6):e44–50. https://doi.org/10.1016/j.fertnstert.2015.03.019.

    Article  Google Scholar 

  9. Practice Committee of the American Society for Reproductive Medicine. Electronic address Aao, Practice Committee of the American Society for Reproductive M. Uterine septum: a guideline. Fertil Steril. 2016;106(3):530–40. https://doi.org/10.1016/j.fertnstert.2016.05.014.

    Article  Google Scholar 

  10. Ludwin A, Pityński K, Ludwin I, Banas T, Knafel A. 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):90–9. https://doi.org/10.1016/j.jmig.2012.09.011.

    Article  Google Scholar 

  11. Pleş L, Alexandrescu C, Ionescu CA, Arvătescu CA, Vladareanu S, Moga MA. Three-dimensional scan of the uterine cavity of infertile women before assisted reproductive technology use. Medicine (Baltimore). 2018;97(41):e12764–4. https://doi.org/10.1097/MD.0000000000012764.

    Article  Google Scholar 

  12. American College of O, Gynecologists’ Committee on Gynecologic P. Technology assessment no. 12: sonohysterography. Obstet Gynecol. 2016;128(2):e38–42. https://doi.org/10.1097/AOG.0000000000001588.

    Article  Google Scholar 

  13. Dijkman AB, Mol BWJ, van der Veen F, Bossuyt PMM, Hogerzeil HV. Can hysterosalpingocontrast-sonography replace hysterosalpingography in the assessment of tubal subfertility? Eur J Radiol. 2000;35(1):44–8. https://doi.org/10.1016/S0720-048X(99)00127-8.

    Article  CAS  PubMed  Google Scholar 

  14. • Levaillant J-M, 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):363–7. https://doi.org/10.1016/j.jogoh.2019.01.008 Introduces an innovative comprehensive examination for evaluating female infertility with a combination of high quality 3D ultrasound and assessment of tubal patency with hysterosalpingo-foam-sonography.

    Article  Google Scholar 

  15. • Exacoustos C, Pizzo A, Lazzeri L, Pietropolli A, Piccione E, Zupi E. Three-dimensional hysterosalpingo contrast sonography with gel foam: methodology and feasibility to obtain 3-dimensional volumes of tubal shape. J Minim Invasive Gynecol. 2017;24(5):827–32. https://doi.org/10.1016/j.jmig.2017.04.007 Demonstrates that the novel hysterosalpingo-foam-sonography is a well-tolerated method for the evaluation of tubal course and patency.

    Article  PubMed  Google Scholar 

  16. Fukunaga T, Fujii S, Inoue C, Mukuda N, Murakami A, Tanabe Y, et al. The spectrum of imaging appearances of Müllerian duct anomalies: focus on MR imaging. Jpn J Radiol. 2017;35(12):697–706. https://doi.org/10.1007/s11604-017-0681-4.

    Article  Google Scholar 

  17. • Volondat M, Fontas E, Delotte J, Fatfouta I, Chevallier P, Chassang M. Magnetic resonance hysterosalpingography in diagnostic work-up of female infertility – comparison with conventional hysterosalpingography: a randomised study. EurRadiol. 2019;29(2):501–8. https://doi.org/10.1007/s00330-018-5572-2 Compares the diagnostic accuracy of MR-HSG with conventional radiographic HSG demonstrating comparable performance and reduced patient discomfort.

    Article  Google Scholar 

  18. Tran-Harding K, Nair RT, Dawkins A, Ayoob A, Owen J, Deraney S, et al. Endometriosis revisited: an imaging review of the usual and unusual manifestations with pathological correlation. Clin Imaging. 2018;52:163–71. https://doi.org/10.1016/j.clinimag.2018.07.017.

    Article  Google Scholar 

  19. Bazot M, Daraï E. Diagnosis of deep endometriosis: clinical examination, ultrasonography, magnetic resonance imaging, and other techniques. Fertil Steril. 2017;108(6):886–94. https://doi.org/10.1016/j.fertnstert.2017.10.026.

    Article  PubMed  Google Scholar 

  20. Steinkeler JA, Woodfield CA, Lazarus E, Hillstrom MM. Female infertility: a systematic approach to radiologic imaging and diagnosis. RadioGraphics. 2009;29(5):1353–70. https://doi.org/10.1148/rg.295095047.

    Article  PubMed  Google Scholar 

  21. Ramanathan S, Kumar D, Khanna M, Al Heidous M, Sheikh A, Virmani V, et al. Multi-modality imaging review of congenital abnormalities of kidney and upper urinary tract. World J Radiol. 2016;8(2):132–41. https://doi.org/10.4329/wjr.v8.i2.132.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Deidre D. Gunn.

Ethics declarations

Conflict of Interest

Carolyn F. Dishuck, Jordan D. Perchik, and Deidre D. Gunn each declare no potential conflicts of interest.

Kristin K. Porter is a section editor for Current Urology Reports.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

This article is part of the Topical Collection on New Imaging Techniques

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Dishuck, C.F., Perchik, J.D., Porter, K.K. et al. Advanced Imaging in Female Infertility. Curr Urol Rep 20, 77 (2019). https://doi.org/10.1007/s11934-019-0942-0

Download citation

  • Published:

  • DOI: https://doi.org/10.1007/s11934-019-0942-0

Keywords

Navigation