Transvaginal sonography in infertility and assisted reproduction

This review on transvaginal sonographic uses in the diagnosis and treatment of infertility evolves from the plethora of data acquired due to the renewed technology of TVS. A combination of its advantages: 1) closer proximity to the pelvic organs and therefore clearer images as compared to abdominal ultrasound, 2) the avoidance of the necessity of full bladder made the TVS gain much popularity in obstetrics and gynecology. Its value is recognized not only by opening a door to early detection of common pathologies of pregnancy--ectopic gestation and fetal malformations, multiple fetuses, and spontaneous fetal reduction ("vanished twin"), but also made visualization of the enlarged fallopian tubes, uterine cervix and corpus and ovarian follicles an almost indispensible adjunct to modern gynecologic infertility workup. The value of TVS seems to increase tremendously not only as an indispensible diagnostic tool but also as a modern means of replacing laparotomy or laparoscopy for follicular aspiration and eggs retrieval for IVF/ET, GIFT and assisted reproduction, reduction of the number of multiple fetuses, and for treatment of most cases of ectopic pregnancy. Its value in the diagnosis and treatment of the infertile couple seems invaluable now and indispensible tomorrow.