The Role of Ultrasonography in In-vitro Fertilization And Embryo Transfer (IVF-ET)

Abstract

BACKGROUND: Although ultrasonography was introduced into Obstetrics and Gynaecology by a British Gynaecologist over five decades ago, the requirement for formal training in its use by gynecologists in Nigeria
is just beginning to catch on, despite its indispensible role in various aspects of our clinical practice.
OBJECTIVE: To describe the role of ultrasonography in in-vitro fertilization and the indispensability of the instrument to reproductive medicine.
METHOD: A review of literature written in English language on the use and application of ultrasonography in in-vitro fertilization was done. The review covered articles published between 1980-2012.
RESULTS: Ultrasound is the most versatile method for pre-treatment assessment in IVF being the dominant instrument for assessing ovarian reserve, pelvic pathologies and for assessing the uterine cavity. The
ability of ultrasonography to measure endometrial thickness in addition to detecting uterine masses gives it an edge over laparoscopy/hysteroscopy as a diagnostic procedure in uterine cavity assessment, although hysteroscopy has the advantage of therapeutic potential. Similarly, ultrasonography is superior to biochemical methods for follicular monitoring because of its ability to demonstrate the number and sizes of follicles, and guide preparations for oocyte retrieval. The relative ease
of ultrasound guided oocyte retrieval; its less technical demands and the possibility of conducting the procedure under local anaesthesia have made ultrasound guided oocyte retrieval more popular across the world.
Randomized controlled trials show that ultrasoundguided transfer techniques have better outcomes than the clinical touch technique in terms of on-going pregnancies and clinical pregnancies. Ultrasonography
is now the key instrument for diagnosing and monitoring pregnancy following embryo transfer, biochemical methods being complimentary.
CONCLUSION: Ultrasonography is now the single most important  instrument in in-vitro fertilization programmes and gynaecologists with interest in reproductive medicine need necessarily to obtain a formal training in its use.

KEY WORDS: ultrasonography, in-vitro fertilization, infertility, assisted reproduction technology