Sonographic diagnosis of pelvic adhesions in patients after ovum pickup

To evaluate the use of transvaginal sonography for the detection of pelvic adhesions by using clear free fluid in the pouch of Douglas found after ovum pickup. A prospective clinical study was performed in an infertility unit of an academic research facility. Sonography was performed in 50 women wit...

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Bibliographic Details
Published in:Journal of ultrasound in medicine 2001-08, Vol.20 (8), p.869-875
Main Authors: Shalev, J, Mashiach, R, Fisch, B, Royburt, M, Bar-Hava, I, Krissi, H, Meizner, I
Format: Article
Language:English
Subjects:
Adnexal Diseases - diagnostic imaging
Adult
Ascitic Fluid - diagnostic imaging
Biological and medical sciences
Douglas' Pouch - diagnostic imaging
Female
Genital system. Mammary gland
Humans
Infertility, Female - diagnostic imaging
Infertility, Female - etiology
Investigative techniques, diagnostic techniques (general aspects)
Laparoscopy
Medical sciences
Ovum Transport
Pelvis - diagnostic imaging
Peritoneal Diseases - diagnostic imaging
Prospective Studies
Reproductive Techniques, Assisted
Tissue Adhesions - complications
Tissue Adhesions - diagnostic imaging
Ultrasonic investigative techniques
Ultrasonography
Uterine Diseases - diagnostic imaging
Uterus - diagnostic imaging
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Summary:To evaluate the use of transvaginal sonography for the detection of pelvic adhesions by using clear free fluid in the pouch of Douglas found after ovum pickup. A prospective clinical study was performed in an infertility unit of an academic research facility. Sonography was performed in 50 women with infertility 3 days after ovum pickup, and the visceral peritoneum of the uterus, the ovaries, and the fallopian tubes was scanned for possible pelvic adhesions. The serosal surfaces of the uterus, ovaries, and fallopian tubes were successfully observed for the presence of adhesions in 86%, 68%, and 20% of the patients, respectively. Improved visualization was associated with an increased amount of pelvic fluid for the uterus (P = .01) but not for the ovaries and fallopian tubes. The amount of fluid in the pelvis correlated with an increased number of retrieved oocytes (P = .07) and a decreased need for manual manipulation to achieve proper imaging of the uterus (P = .001). Transvaginal sonography performed in the presence of fluid in the pelvis may show adhesions mainly attached to the uterus and ovaries. Assessment of possible mechanical factors is important in planning treatment of patients with infertility.
ISSN:0278-4297
1550-9613
DOI:10.7863/jum.2001.20.8.869