Three-dimensional ultrasound (3D US) is now a well-developed technology; and it has proved its superiority over the B mode US in several applications. Infertility may be due to female factor as well as male factor (40–45%). For the assessment of the female, transvaginal scan is the scanning method of choice and the first-line investigation. Adding dynamic examination, Doppler and 3D US markedly increases the information available. Three-dimensional US can be used for assessment of uterine congenital anomalies, intrauterine pathologies, adnexal lesions, tubal patency assessment, polycystic ovaries, ovarian follicular monitoring, and endometrial receptivity assessment. Three-dimensional US can better demonstrate the uterine lesions, such as polyps, endometrial synechiae, and fibroids. Better delineation of endometriomyometrial junction helps diagnosis of adenomyosis comparable to MRI. Tubal assessment can be made more effective by adding 3D to hysterosalpingocontrast sonography. Three-dimensional US is accurate for volume assessment for both follicles and endometrium, which are much more reliable parameters than follicular diameter or endometrial thickness. The presence of cumulus, the presence of which can be confirmed by 3D US more easily than with B mode and increases the surety of the presence of a mature ova in the follicle. Three-dimensional power Doppler gives an idea about global vascularity of the follicle and endometrium. However, larger studies are still needed to establish more precise values of 3D ultrasonography in the assessment of female infertility.
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