Sonographic evaluation of normal and induced ovulation.

Abstract

The adult premenopausal ovary exists in a dynamic state of flux, with ovarian position, size, activity, and structure constantly undergoing changes. Pelvic sonograms must be interpreted with knowledge of the stage of the menstrual cycle and the expected normal range of sonographic findings, because features that are normal in one phase may be abnormal in another. Only against this background knowledge can the challenging task of interpretation of pelvic sonograms be successfully performed. US also plays an increasingly important role in monitoring ovulation induction and alternative methods of fertilization and has improved pregnancy rates by distinguishing between the presence of one or more mature follicles as opposed to a cohort of immature follicles, suggesting the possibility of multiple ovulation with the risks of hyperstimulation or poor pregnancy outcome from multiple gestation, indicating optimum timing of human chorionic gonadotropin administration, allowing detection and confirmation of normal follicular rupture and ovulation, indicating optimum timing of oocyte retrieval in programs of in vitro fertilization with embryo transfer (IVF-ET) or insemination programs, and assessing pathologic pelvic conditions and ovarian accessibility in IVF-ET programs. Oocyte retrieval and embryo transfer are also being performed under US guidance.

Follicular Monitoring: Comparison of Transabdominal and Transvaginal Sonography

“…After Hackeloer's pioneering study [3] of the morphological changes in ovary during normal cycles m-any studies have been conducted to evaluate cyclic changes in the ovaries both during normal and stimulated cycles [1,2,[4][5][6]. After the introduction of TV scanning method many investigators concentrated on the accuracy of assessment of follicular dynamics [7][8][9].…”

“…Follicular monitoring is one of the various applications of ultrasound in the management of infertility. Ultrasound is unique in its ability to document the morphologic changes in the ovary and uterus during normal and induced cycles [1,2]. Hackeloer [3] in 1978, was the first to demonstrate with ultrasound the sequential events of ovary in the normal menstrual cycle.…”

“…Hackeloer [3] in 1978, was the first to demonstrate with ultrasound the sequential events of ovary in the normal menstrual cycle. After that several studies were done in early eighties regarding sonographic evaluation of normal and induced ovulation [1,2,[4][5][6]. With the introduction of transvaginal ultrasonography, between 1983-1985 the scenario changed rapidly.…”

Imaging of Adnexal Masses in Pregnancy

“…Ovarian hyperstimulation syndrome appears as markedly enlarged ovaries containing multiple, large, peripherally located, thin-walled cysts that sometimes exude fluid from hemorrhage or ascites. 7 The large ovaries are at risk of torsion ( Figure 9) and hemorrhage, but usually they regress spontaneously later in pregnancy or after delivery. 7 …”

“…7 The large ovaries are at risk of torsion ( Figure 9) and hemorrhage, but usually they regress spontaneously later in pregnancy or after delivery. 7 …”