UTERINE EVALUATION

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METHODS OF UTERINE IMAGING

Although uterine pathologies are relatively uncommon causes of infertility, evaluation of the endometrial cavity prior to initiating infertility treatment remains an important part of the workup. Currently there are four basic methods for evaluation of the uterus, which include:

  • Transvaginal (Pelvic) Ultrasound (TVS)
  • Fluid Ultrasound (Hydrosonography)
  • Hysterosalpingogram (HSG)
  • Hysteroscopy

Each of these four methods has its advantages and limitations, and therefore it is important to determine which method to select for the specific clinical problem. All methods are utilized in the first part of the menstrual cycle (at the end of menses) to minimize the risk of infection, avoid interference from intrauterine blood and clots, and an early intrauterine pregnancy. Alternatively, evaluation can be done anytime while on birth control pills.

In addition, fertility specialist may perform an endometrial biopsy to evaluate the endometrial lining of the uterus to obtain an objective assessment of ovulation or to rule out “luteal phase defect” (LPD).