Evaluation of Infertility

  • Gertraud Heinz-PeerEmail author
Part of the Medical Radiology book series (MEDRAD)


Infertility is defined as 1 year of unprotected intercourse that does not result in pregnancy (Hornstein and Schust 1996). Infertility is estimated to affect up to 10% of women of reproductive age (Heinonen et al. 1982). Although uterine pathology accounts for <10% of cases, uterine imaging is important not only for establishing a specific diagnosis, but also for directing corrective therapy (Collins and Woodward 1995; Lev-Toaff 1996). Knowledge of structural abnormalities may indicate potential pregnancy complications including spontaneous abortion, intrauterine growth retardation, preterm delivery, malpresentation, and retained products of conception.


  1. Bacelar AC, Wilcock D, Powell M, Worthington BS (1995) The value of MRI in the assessment of traumatic intrauterine adhesions (Asherman syndrome). Clin Radiol 50:80–83CrossRefGoogle Scholar
  2. Bartynski WS, Lin L (1997) Dynamic and conventional spin-echo MR of pituitary microlesions. AJNR Am J Neuroradiol 18:965–972PubMedGoogle Scholar
  3. Becker E Jr, Lev-Toaff AS, Kaufman EP, Halpern EJ, Edelweiss MI, Kurtz AB (2002) The additional value of transvaginal sonohysterography over transvaginal sonography alone in women with known or suspected leiomyoma. J Ultrasound Med 21:237–247CrossRefGoogle Scholar
  4. Braly PS (1999) Disease of the uterus. In: Scott JR, Di-Saia PJ, Hammond CB, Spellacy WN (eds) Danforth’s obstetrics and gynecology, 8th edn. Lippincott Williams & Wilkins, Philadelphia, PA, pp 837–855Google Scholar
  5. Brody JM, Koelliker SL, Fishman GN (1998) Unicornuate uterus: imaging appearance, associated anomalies and clinical implications. AJR Am J Roentgenol 171:1341–1347CrossRefGoogle Scholar
  6. Buttram VC, Gibbons WE (1979) Müllerian anomalies: a proposed classification (an analysis of 144 cases). Fertil Steril 32:40–46CrossRefGoogle Scholar
  7. Carrington BM, Hricak H, Nuruddin RN, Secaf E, Laros RK Jr, Hill EC (1990) Müllerian duct anomalies: MR imaging evaluation. Radiology 176:715–720CrossRefGoogle Scholar
  8. Collins JI, Woodward PJ (1995) Radiological evaluation of infertility. Semin Ultrasound CT MR 16:304–316CrossRefGoogle Scholar
  9. Fielding JR (1996) MR imaging of müllerian anomalies: impact on therapy. AJR Am J Roentgenol 167:1491–1495CrossRefGoogle Scholar
  10. Fleischer AC, Kepple DM (1997) Normal pelvic anatomy as depicted by various sonographic techniques. In: Fleischer AC, Javitt HC, Jeffrey RB Jr, Jones HW III (eds) Clinical gynaecologic imaging, Philadelphia, PA, Lippincott-Raven, pp 10–22Google Scholar
  11. Goldberg JM, Falcone T, Attaran M (1997) Sonohysterographic evaluation of uterine anomalies noted on hysterosalpingography. Hum Reprod 12:1251–1253CrossRefGoogle Scholar
  12. Heinonen PK, Saarikoski S, Pystynen P (1982) Reproductive performance of women with uterine anomalies: an evaluation of 182 cases. Acta Obstet Gynecol Scand 61:157–162CrossRefGoogle Scholar
  13. Hornstein MD, Schust D (1996) Infertility. In: Berek JS, Adashi EY, Hillard PA (eds) Novak’s gynecology, 12th edn. Lippincott Williams & Wilkins, Baltimore, MD, pp 915–962Google Scholar
  14. Imaoka I, Wada A, Matsuo M, Yoshida M, Kitagaki H, Sugimura K (2003) MR imaging of disorders associated with female infertility: use in diagnosis, treatment, and management. Radiographics 23:1401–1421CrossRefGoogle Scholar
  15. Javitt MC (1997) Magnetic resonance imaging in the diagnosis of congenital uterine anomalies. In: Fleischer AC, Javitt MC, Jeffresy RB Jr, Jones HW Jr (eds) Clinical gynaecologic imaging. Lippincott-Raven, Philadelphia, pp 299–310Google Scholar
  16. Justesen P, Rasmussen F, Anderson PE Jr (1986) Inadvertently performed hysterosalpingography during early pregnancy. Acta Radiol Diagn (Stockh) 27:711–713CrossRefGoogle Scholar
  17. Kimura I, Togashi K, Kawakami S et al (1996) Polycystic ovaries: implications of diagnosis with MR imaging. Radiology 201:549–552CrossRefGoogle Scholar
  18. Kupesic S, Kurjak A (2000) Ultrasound and Doppler assessment of uterine anomalies. In: Kupesic S, de Ziegler D (eds) Ultrasound and infertility Pearl River. Parthenon, New York, NY, pp 147–153Google Scholar
  19. Kurman RJ, Mazur MT (1987) Benign diseases of the endometrium. In: Kurman RJ (ed) Blaustein’s pathology of the female genital tract, 3rd edn. Springer, New York, pp 292–321CrossRefGoogle Scholar
  20. Lev-Toaff AS (1996) Sonohysterography: evaluation of endometrial and myometrial abnormalities. Semin Roentgenol 31:288–298CrossRefGoogle Scholar
  21. Lindheim SR, Sprague C, Winter TC III (2006) Hysterosalpingography and sonohysterography: lessions in technique. AJR Am J Roentgenol 186(1):24–29CrossRefGoogle Scholar
  22. Lujan ME, Jarrett BY, Brooks ED, Reines JK, Peppin AK, Muhn N, Haider E, Pierson RA, Chizen DR (2013) Updated ultrasound criteria for polycystic ovary syndrome: reliable thresholds for elevated follicle population and ovarian volume. Hum Reprod 28(5):1361–1368CrossRefGoogle Scholar
  23. Margolin FR (1988) A new cannula for hysterosalpingography. AJR 151:729–730CrossRefGoogle Scholar
  24. Miki Y, Matsuo M, Nishizawa S et al (1990) Pituitary adenomas and normal pituitary tissue: enhancement patterns on gadopentate-enhanced MR imaging. Radiology 177:35–38CrossRefGoogle Scholar
  25. Mitchell DG, Gefter WB, Spritzer CE et al (1986) Polycystic ovaries: MR imaging. Radiology 160:425–429CrossRefGoogle Scholar
  26. Nicolini U, Bellotti M, Bonazzi B, Zamberletti D, Candiani GB (1987) Can ultrasound be used to screen uterine malformations? Fertil Steril 47:89–93CrossRefGoogle Scholar
  27. Outwater EK, Siegelman ES, Chiowanich P, Kilger AM, Dunton CJ, Talerman A (1998) Dilated fallopian tubes: MR imaging characteristics. Radiology 208:463–469CrossRefGoogle Scholar
  28. Patton PE (1994) Anatomic uterine defects. Clin Obstet Gynecol 37:705–721CrossRefGoogle Scholar
  29. Pellerito JS, McCarthy SM, Doyle MB et al (1992) Diagnosis of uterine anomalies: relative accuracy of MR imaging, endovaginal sonography, and hysterosalpingography. Radiology 183:795–800CrossRefGoogle Scholar
  30. Pittaway DE, Winfield AC, Maxson W, Daniell J, Herbert C, Wentz AC (1983) Prevention of acute pelvic inflammatory disease after hysterosalpingography: efficacy of doxycycline prophylaxis. Am J Obstet Gynecol 147:623–626CrossRefGoogle Scholar
  31. Rock JA (1997) Surgery for anomalies of the müllerian ducts. In: Rock JA, Thompson JD (eds) Te Linde’s operative gynecology, 8th edn. Lippincott-Raven, Philadelphia, Pa, pp 687–729Google Scholar
  32. Rock JA, Jones HW Jr (1977) The clinical management of the double uterus. Fertil Steril 28:798–806CrossRefGoogle Scholar
  33. Sadowski EA, Elizabeth A, Jennifer E, Ochsner JE, Jody M, Riherd JM, Frank R, Korosec FR, Agrawal G, Pritts EA, Klie MA (2008) MR hysterosalpingography with an angiographic time-resolved 3D pulse sequence: assessment of tubal patency. AJR Am J Roentgenol 191:1381–1385CrossRefGoogle Scholar
  34. Schenken RS (1999) Endometriosis. In: Scott JR, Di-Saia PJ, Hammond CB, Spellacy WN (eds) Danforth’s obstetrics and gynecology, 8th edn. Lippincott Williams & Wilkins, Philadelphia, PA, pp 669–675Google Scholar
  35. Sholkoff SD (1987) Balloon hysterosalpingography catheter. AJR 149:995–996CrossRefGoogle Scholar
  36. Soules MR, Spadoni LR (1982) Oil versus aqueous media for hysterosalpingography: a continuing debate based on many options and few facts. Fertil Steril 38:1–11CrossRefGoogle Scholar
  37. Strübbe EH, Willemsen WNP, Lemmens JAM, Thijn CJP, Rolland R (1993) Mayer-Rokitansky-Küster-Hauser syndrome: distinction between two forms based on excretory urographic, sonographic, and laparoscopic findings. AJR Am J Roentgenol 160:331–334CrossRefGoogle Scholar
  38. The American Fertility Society classifications of adnexal adhesions, distal tubal obstruction, tubal occlusion secondary to tubal ligation, tubal pregnancies, müllerian anomalies and intrauterine adhesions (1988). Fertil Steril 49:944–955Google Scholar
  39. Thompson JD, Rock JA (1997) Leiomyoma uteri and myomectomy. In: Rock JA, Thompson JD (eds) Te Linde’s operative gynecology, 8th edn. Lippincott-Raven, Philadelphia, PA, pp 731–770Google Scholar
  40. Thurmond AS, Uchida BT, Rosch J (1990) Device for hysterosalpingography and fallopian tuber catherization. Radiology 174:571–572CrossRefGoogle Scholar
  41. Togashi K, Nishimura K, Itoh K, Fujisawa I, Nakano Y, Torizuka K, Ozasa H, Ohshima M (1987) Vaginal agenesis: classification by MR imaging. Radiology 162:675–677CrossRefGoogle Scholar
  42. Tukeva TA, Aronen HJ, Karjalainen PT, Molander P, Paavonen T, Paavonen J (1999) MR imaging in pelvic inflammatory disease: comparison with laparoscopy and US. Radiology 210:209–216CrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG 2017

Authors and Affiliations

  1. 1.Department of Medical and Interventional RadiologyUniversity Hospital St. PöltenSt. PöltenAustria

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