Title: The role of ultrasonography in the investigation of sub- fertile couples

Biography:

Humaira Islam Khan has achieved her MBBS degree from Dhaka Medical College and Hospital in 1986. She then went on to get her fellowship in ultrasonography from New England Medical Centre Hospitals (Tufts University). She has been serving as a consultant sonologist at Anwer Khan Modern Hospital and Diagnostic Centre for more than 20 years.

Abstract

The inability to conceive is extremely stressful for sub-fertile couples. Oftener than not, such patients slide into depression, also affecting other members of the family. Ultrasound scanning is radiation-free, less expensive, non-invasive, and hence repeatable to patients with infertility. Almost all abnormalities of the male and female reproductive system is easily detectable. 

Infertility is a “disease of the reproductive system defined by the failure to a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse”. We find the use of Ultrasonography extremely rewarding as the first line of investigation in female infertility. The objective of use of USG is to  identify causes of abnormalities of uterus, fallopian tubes, ovaries etc. In male patients, ultrasound identifies testicular and epididymal pathologies.  It detects varicocele, prostatic and seminal vessels abnormalities. 

The investigation of infertility is a multi-disciplinary method. USG scanning of sub-fertile couples follow the stages of identifying causes, formulating treatment plans, responding to emotional needs when treatment fails and monitoring a pregnancy when established. Ultrasonography is used to formulate treatment programs, which open us with follicular tracking and ovulation in both natural and induced cycles. USG is used to monitor the changes of endometrium required for a successful conception. Tubal abnormalities e.g. hydrosalpinx can also be detected. This marks that USG is also used as a diagnostic procedure of fibroids and endometriosis. Therapeutic USG is used for follicular monitoring and interventional USG is used for oocyte retrieval for IVF. Other procedures such as hysterosalpingogram is a popular method to detect tubal pathologies  and uterine wall irregularities. 

Along with HSG, MRI is also a radiation free procedure for the diagnosis of uterine mass such as adenomyosis and other pathologies. Ultrasonogram along with radiologic and Sono HSG, MRI and blood workup are the screening procedure of the diagnosis, management of causes of infertility and its complications.