Sonoendocrinology and monitoring assisted reproduction technology

Abstract

Reproductive function in a human being consists of continuous hormonal changes in the female. These hormonal changes are responsible for dynamic changes occurring in the ovarian and uterine morphology and vascularity. Ultrasound and Doppler are very useful modalities for assessing these changes, and therefore, very effective for diagnosis of hormonal derangements and monitoring the assisted reproductive technology (ART) treated cycles. Among the common hormones that need to be assessed, androgen can be correlated with high antral follicle count (AFC) and high uterine artery resistance and anti-Müllerian hormone (AMH) also has a positive correlation with AFC. Follicle-stimulating hormone (FSH) is reflected as follicular growth, and luteinizing hormone (LH) by ovarian stromal echogenicity and vascularity and endometrial hyperechogenicity. Estrogen adequacy can be judged by follicular and endometrial flow in preovulatory phase whereas progesterone adequacy can be judged by corpus luteal and endometrial flow in mid luteal phase. Day-to-day hormonal assessment can therefore be replaced by ultrasound and Doppler during ART.