Preimplantation 3D ultrasound: current uses and challenges

Area of Science:

• Reproductive Endocrinology and Infertility
• Diagnostic Imaging
• Gynecologic Ultrasound

Background:

• Preimplantation ultrasound (US) is crucial for optimizing outcomes in assisted reproductive techniques (ART).
• A systematic, evidence-based approach to transvaginal 3D US is proposed for the early follicular phase.
• This method enhances the evaluation of the uterus and adnexa.

Purpose of the Study:

• To establish a systematic protocol for transvaginal 3D US prior to ART.
• To detail the comprehensive assessment of uterine and adnexal structures.
• To improve the planning and success rates of infertility treatments.

Main Methods:

• Transvaginal 3D US examination in the early follicular phase.
• Systematic evaluation of uterine shape, size, contour, endometrium (thickness, volume, pattern, vascularity), and junctional zone.
• Assessment of adnexa for masses, endometriosis, and tubal patency using techniques like Hy-Co-Sy and SIS.

Main Results:

• Detailed protocol for assessing uterine cavity, myometrium, endometrium, and adnexa.
• Inclusion of specific techniques like Saline Infusion Sonohysterography (SIS) and Hysterosalpingo-contrast-sonography (Hy-Co-Sy).
• Emphasis on evaluating ovarian vascularity, antral follicle count, and adnexal structures.

Conclusions:

• A systematic transvaginal 3D US protocol provides a comprehensive preimplantation assessment.
• This approach optimizes the evaluation of infertility factors, aiding in better ART planning.
• Standardized imaging improves the detection of abnormalities and enhances treatment outcomes.