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Ultrasound evaluation has many applications in all areas of medicine. In infertility, it is used to help identify many conditions, such as fibroids, polyps, visualize the uterus, ovaries, and other structures. The most commonly applied type of ultrasound in infertility is the transvaginal ultrasound where the probe is painlessly inserted into the vagina. Ultrasound creates images using sound waves whereas X-rays use radiation.
The transvaginal ultrasound has many applications in assisted reproductive technology (IVF) cycles. The development of the follicles can be directly observed and these data are used to help determine FSH dosing. Follicular rupture can also be documented. The endometrium must thicken to accept an embryo and its width can be measured using ultrasound. IVF patients have several ultrasound examinations during their stimulation cycles. Ultrasound is also often used to monitor Clomid and FSH IUI cycles.
The transvaginal ultrasound is also used in the egg retrieval process known as "ultrasound-guided transvaginal oocyte retrieval". The fertility specialist uses the ultrasound to visualize the ovaries and follicles enabling him/her to precisely puncture the follicles and retrieve the eggs.
The lining of the uterus (endometrium) thickens and becomes more vascular during the ovulatory cycle under stimulation by progesterone and estrogen. This is necessary for implantation and nourishment of the embryo.
Once the eggs are ovulated from the follicle, the remaining follicular structure on the ovary is known as the corpus luteum. During the luteal phase of the cycle, the corpus luteum produces progesterone to stimulate endometrial development. Inadequate progesterone production can lead to poor endometrial development and a condition termed "a luteal phase defect".
The endometrial biopsy involves removing a small amount of endometrial tissue approximately 12 days after ovulation and examining it under the microscope. The procedure is conducted at our Dallas, Tx fertility clinic. The "stage" of endometrial cell development is correlated with the cycle day to learn if a luteal phase defect is present. An "out of phase" biopsy will not demonstrate the typical endometrial cell development.
If a luteal phase defect is identified, progesterone is administered in the next cycle and is usually very effective in stimulating endometrial development.
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