Abstract
The purpose of this pictorial review is to discuss causes of female infertility, in particular, those etiologies in which imaging plays a key role in detection. Included are disorders of cervical, ovarian, fallopian tube, and uterine origin. We also discuss the role of various imaging modalities including hysterosalpingography, pelvic ultrasonography, hysterosonography, and pelvic MR imaging in elucidating the cause of female infertility. Radiologists need to know the conditions to be aware of when these patients are sent for diagnostic imaging, as well as how to direct further management, if necessary, should an abnormality be detected.
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References
McLaren JF (2012) Infertility evaluation. Obstet Gynecol Clin North Am 39:453–463
Chandra A, Martinez GM, Mosher WD, Abma JC, Jones J (2005) Fertility, family planning, and reproductive health of U.S. women: data from 2002 National Survey of Family Growth. Vital Health Stat 23(25):1–160
Imaoka I, Wada A, Matsuo M, et al. (2003) MR imaging of disorders associated with female infertility: use in diagnosis, treatment, and management. Radiographics 23(6):1401–1421
Poon WW, McCoshen JA (1985) Variances in mucus architecture as a cause of cervical factor infertility. Fertil Steril 44:361–365
Suh-Burgmann EJ, Whall-Strojwas D, Chang Y, Hundley D, Goodman AK (2000) Risk factors for cervical stenosis after loop electrocautery excision procedure. Obstet Gynecol 96:657–660
Tukeva TA, Aronen HJ, Karjalainen PT, et al. (1999) MR imaging in pelvic inflammatory disease: comparison with laparoscopy and US. Radiology 210:209–216
Thurmond AS (2003) Imaging of female infertility. Radiol Clin North Am 41:757–767
Krysiewicz S (2003) Infertility in women: diagnostic evaluation with hysterosalpingography and other imaging techniques. AJR Am J Roentgenol 159:253–261
Ha HK, Lim GY, Cha ES, et al. (1995) MR imaging of tubo-ovarian abscess. Acta Radiol 36:510–514
Eskenazi B, Warner ML (1997) Epidemiology of endometriosis. Obstet Gynecol Clin North Am 24:235–238
Patel MD, Feldstein VA, Chen DC, Lipson SD, Filly RA (1999) Endometriomas: diagnostic performance of US. Radiology 210:739–745
Glastonbury CM (2002) The shading sign. Radiology 224:199–201
Hendriks DJ, Mol BW, Bancsi LF, et al. (2005) Antral follicle count in the prediction of poor ovarian reserve and pregnancy after in vitro fertilization: a meta-analysis and comparison with basal follicle-stimulating hormone level. Fertil Steril 83:291–301
Azziz R, Carmina E, Dewailly D, et al. (2009) The androgen excess and PCOS society criteria for the polycystic ovary syndrome: the complete task form report. Fertil Steril 91:456–488
Matalliotakis IM, Katsikis IK, Panidis DK (2005) Adenomyosis: what is the impact on infertility? Curr Opin Obstet Gynecol 17:261–264
Kunz G, Beil D, Huppert P, et al. (2005) Adenomyosis in endometriosis-prevalence and impact on fertility. Evidence from magnetic resonance imaging. Hum Reprod 20:2309–2316
Steinkeler JA, Woodfield CA, Lazarus E, Hillstrom MM (2009) Female infertility: a systemic approach to radiologic imaging and diagnosis. Radiographics 29:1353–1370
Revel A (2012) Defective endometrial receptivity. Fertil Steril 97:1028–1032
Yu D, Wong YM, Cheong Y, Xia E, Li TC (2008) Asherman syndrome: one century later. Fertil Steril 89:759–779
Troiano RN, McCarthy SM (2004) Müllerian duct anomalies: imaging and clinical issues. Radiology 233:19–34
Saravelos SH, Cocksedge KA, Li TC (2008) Prevalence and diagnosis of congenital uterine anomalies in women with reproductive failure: a critical appraisal. Hum Reprod Update 14:415–429
Buttram VC, Gibbons WE (1979) Müllerian anomalies: a proposed classification (an analysis of 144 cases). Fertil Steril 32:40–46
Golan A, Langer R, Bukovsky I, Caspi E (1989) Congenital anomalies of the Müllerian system. Fertil Steril 51:747–755
Grimbizis GF, Camus M, Tarlatzis BC, Bontis JN, Devroey P (2001) Clinical implications of uterine malformations and hysteroscopic treatment results. Hum Reprod Update 7:161–174
The American Fertility Society (1988) Classifications of adnexal adhesions, distal tubal occlusion, tubal occlusion secondary to tubal ligation, tubal pregnancies, Müllerian anomalies and intrauterine adhesions. Fertil Steril 49:944–955
Rolen AC, Choquette AJ, Semmens JP (1966) Rudimentary uterine horn: obstetric and gynecologic implications. Obstet Gynecol 27:806–813
Sarto GE, Simpson JL (1978) Abnormalities of the Müllerian and wolffian duct systems. Birth Defects 14:37–54
Olive DL, Henderson DY (1987) Endometriosis and Müllerian anomalies. Obstet Gynecol 69:412–415
Uğur M, Turan C, Mungan T, et al. (1995) Endometriosis in association with Müllerian anomalies. Gynecol Obstet Invest 40:261–264
Golan A, Langer R, Wexler S, et al. (1990) Cervical cerclage-its role in the pregnant anomalous uterus. Int J Fertil 35:164–170
Raga F, Bauset C, Remohi J, et al. (1997) Reproductive impact of congenital Müllerian anomalies. Hum Reprod 12:2277–2281
Woelfer B, Salim R, Banerjee S, et al. (2001) Reproductive outcomes in women with congenital uterine anomalies detected by three-dimensional ultrasound screening. Obstet Gynecol 98:1099–1103
Kaufman RH, Adam E, Binder GL, Gerthoffer E (1980) Upper genital tract changes and pregnancy outcome in offspring exposed in utero to diethylstilbestrol. Am J Obstet Gynecol 137:299–308
Kaufman RH (1982) Structural changes of the genital tract associated with in utero exposure to diethylstilbestrol. Obstet Gynecol Ann 11:187–202
Verloop J, van Leeuwen FE, Helmerhorst TJ, van Boven HH, Rookus MA (2010) Cancer risk in DES daughters. Cancer Causes Control 21:999–1007
Buttram VCJr, Reiter RC (1981) Uterine leiomyomata: etiology, symptomatology, and management. Fertil Steril 36:433–445
Dunnez J, Jadoul P (2002) What are the implications for myomas on fertility? A need for debate? Hum Reprod 17:1424–1430
Farhi J, Ashkenazi J, Feldberg D, et al. (1995) Effect of uterine leiomyomata on the results of in vitro fertilization treatment. Hum Reprod 10:2576–2578
Surrey ES, Lietz AK, Schoolcraft WB (2001) Impact of intramural leiomyomata in patients with a normal endometrial cavity on in vitro fertilization-embryo transfer cycle outcome. Fertil Steril 75:405–410
Somigliana E, Vercellini P, Daguati R, et al. (2007) Fibroids and female reproduction: a critical analysis of the evidence. Hum Reprod Update 13:465–476
Kolankaya A, Arici A (2006) Myomas and assisted reproductive technologies: when and how to act? Obstet Gynecol Clin North Am 33:145–152
Klatsky PC, TranND Caughey AB, Fujimoto VY (2008) Fibroids and reproductive outcomes: a systematic literature review from conception to delivery. Am J Obstet Gynecol 198:357–366
Pérez-Medina T, Bajo-Arenas J, Salazar F, et al. (2005) Endometrial polyps and their implication in the pregnancy rates of patients undergoing intrauterine insemination: a prospective, randomized study. Hum Reprod 20:1632–1635
Acknowledgments
The authors gratefully acknowledge Mary C. Frates, MD for contributing the sonographic image in Fig. 26.
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Sadow, C.A., Sahni, V.A. Imaging female infertility. Abdom Imaging 39, 92–107 (2014). https://doi.org/10.1007/s00261-013-0040-6
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DOI: https://doi.org/10.1007/s00261-013-0040-6