3D ultrasound is an emerging technology with great promise to further this role. This overview describes and illustrates the applications of three-dimensional Transvaginal ultrasound in female infertility.
The obvious advantages are that 3D ultrasound offers more rapid and reproducible image acquisition as well as enhanced visualization and post-processing capabilities. Ongoing research will likely continue to define the clinical role of 3D ultrasound and it is possible in the near future to regard to 3D ultrasound as the Golden Standard for pelvic imaging.
Uterine cavity assessment
The main advantage of pre cycle assessment using 3D is the coronal view of the uterine cavity to exclude Mullerian anomalies
Uterine cavity lesions such as fibroids (submucous, Intramural and subserous) , endometrial polyps & IU Synechiae
Ovarian volume calculation
3D ultrasound is more accurate in determining ovarian volume using the Virtual Organ computer-aided Analysis (VOCAL, GE Kretz) technique.
This technique employs a rotational method which involves the manual delineation of the ovarian volume throughout several planes as the data set is rotated through 180 degrees in a consecutive series of rotations
Number of follicles at the early follicular phase has been reported to be a good test for prediction of ovarian response All follicles < 10mm are measured using 2D ultrasound in the longitudinal and transverse planes, however 3D techniques are now available for automatic calculation
The uterine abnormality most commonly associated with miscarriages is a uterine septum
Normal uterine lining does not grow over a septum, so if the embryo implants in the septum, it will not have an adequate blood supply for growth.
The traditional way to correct a septum was performing an abdominal surgery called a "metroplasty", where the septum was removed, and the uterine walls sewn together.
This surgery was not very successful, and nowadays we can remove a septum by hysteroscopy (``HYSTEROSCOPY GUIDED RESECTION``), which provides a much more successful outcome.
Understanding the type of uterine defect one has is critical, because this will determine if surgical intervention is needed to optimize one's chances of a successful pregnancy.
A 2D ultrasound can suggest that an abnormality is present, but does not necessarily differentiate among subtle abnormalities. The advantage of 3D/4D ultrasound is that it will better define the specific defect present. Based on this improved image, the best recommendation can be made
Using ultrasound imaging in implantation Optimal conditions of implantation could be:- Endometrium > 7 mm, Endometrial volume > 2 ml , Dominant follicle >18mm, Hypo-echogenic endometrium with 3 well delineated layers, Uterine PI < 3 and the Presence of sub-endometrial vascular flow.
We use a LOGIQ C5 Premium Ultrasound machine for our Oocyte retrievals and Embryo transfers.
LOGIQ C5 Professional Ultrasound – at our Banjara hills OPD