Infertility in women: diagnostic evaluation with hysterosalpingography and other imaging techniques

This article examines the current roles of hysterosalpingography and other imaging studies used in diagnostic assessment and treatment of infertility in women. The advantages and limitations of hysterosalpingography, transabdominal or transvaginal sonography, and MR imaging in detecting abnormalities of the uterus (congenital anomalies, intrauterine adhesions, myometrial and endometrial derangements) and tubal and peritubal disease are presented. The use of sonography to evaluate cyclical endometrial changes, to assess development of the follicle and corpus luteum, to determine whether ovulation has occurred, and to detect dysfunctional ovulatory dynamics is described, as is the role of this technique in improving the prognostic value of the postcoital test for assessing the quality of cervical mucus. With the development and availability of newer and improved methods for the treatment of infertility disorders in women, comprehensive and detailed evaluation to determine the precise underlying cause or causes of the infertility is important to allow formulation of the most appropriate therapeutic plan. With careful and thorough assessment, the cause of infertility can be identified in 90-95% of couples evaluated.