Introduction: Volume ultrasound (US) is an important complementary addition to the brightness (B) mode and Doppler transvaginal assessment of the reproductive organs in patients presenting with fertility problems. It has an important role in pretreatment assessment and also the monitoring of the treatment cycles and decision-making on the treatment protocols. Discussion points: Three-dimensional (3D) US is a modality of choice for differential diagnosis of Mullerian abnormalities. When used with Doppler and saline infusion sonohysterography (SIS), 3D US may almost eliminate the need for diagnostic hysteroscopy. It can be used to confidently diagnose polyps, hyperplasia, synechiae, chronic endometritis (CE), etc., all endometrial pathologies. A 3D US is considered a modality, at par with magnetic resonance imaging (MRI), for the assessment of endometrio-myometrial junction and so for the diagnosis of adenomyosis. It also enables the documentation of endometrial invasion in adenomyosis. In cases with submucosal fibroids, it is the 3D US that allows a clear assessment of the extent of endometrial invasion or distortion. The 3D US also has a role in uterine scar and cervical assessment. A 3D hystero-salpingo contrast sonography (HyCoSy) is an excellent modality for the assessment of tubal patency. Virtual organ computer-aided analysis (VOCAL) and sonography-based automated volume count (SonoAVC) are volume calculation software and are very useful for the assessment of ovarian volume, stromal volume, follicular, and endometrial volume, and for the accurate calculation of antral follicle count (AFC). When combined with power, Doppler can give a precise assessment of the global vascularity of these structures that can be all used to improve the assisted reproductive technology (ART) results. A 3D US can also be used to predict and diagnose the complications of ART, like ovarian hyperstimulation syndrome (OHSS) and ectopic pregnancies.
Petanovski Z, Kurjak A. 3D-4D ultrasound in gynecology. Jaypee Brothers 2022;129–147.
Grimbizis GF, Gordts S, Di Spiezio Sardo A, et al. The ESHRE/ESGE consensus on the classification of female genital tract congenital anomalies. Hum Reprod 2013;28(8):2032–2044. DOI: 10.1093/humrep/det098
Salim R, Woelfer B, Backos M. Reproducibility of three-dimensional ultrasound diagnosis of congenital uterine anomalies. Ultrasound Obstet Gynecol 2003;21(6):578–582. DOI: 10.1002/uog.127. PMID: 12808675
Exacoustos C, Brienza L, Di Giovanni A, et al. Adenomyosis: three-dimensional sonographic findings of the junctional zone and correlation with histology. Ultrasound Obstet Gynecol 2011;37(4):471–479. DOI: 10.1002/uog.8900
Reinhold C, McCarthy S, Bret PM, et al. Diffuse adenomyosis: comparison of endovaginal US and MR imaging with histopathologic correlation. Radiology 1996;199(1):151–158. DOI: 10.1148/radiology.199.1.8633139
Outwater EK, Siegelman ES, Van Deerlin V. Adenomyosis: current concepts and imaging considerations. Am J Roentgenol 1998;170(2):437–441. DOI: 10.2214/ajr.170.2.9456960
Togashi K, Nishimura K, Itoh K, et al. Adenomyosis: diagnosis with MR imaging. Radiology 1988;166(1 Pt 1):111–114. DOI: 10.1148/radiology.166.1.3336669
Bazot M, Cortez A, Darai E, et al. Ultrasonography compared with magnetic resonance imaging for the diagnosis of adenomyosis: correlation with histopathology. Hum Reprod 2001;16(11):2427–2433. DOI: 10.1093/humrep/16.11.2427
Lasmar RB, Barrozo PR, Dias R, et al. Submucous myomas: a new presurgical classification to evaluate the viability of hysteroscopic surgical treatment–preliminary report. J Minim Invasive Gynecol 2005;12(4):308–311. DOI: 10.1016/j.jmig.2005.05.014
Raine-Fenning N, Jayaprakasan K, Deb S. Three-dimensional ultrasonographic characteristics of endometriomata. Ultrasound Obstet Gynecol 2008;(6):718–724. DOI: 10.1002/uog.5380
Atri M, Nazarnia S, Bret PM, et al. Endovaginal sonographic appearance of benign ovarian masses. Radiographics 1994;14(4):747–760. DOI: 10.1148/radiographics.14.4.7938766
Patel MD, Feldstein VA, Lipson SD, et al. Cystic teratomas of the ovary: diagnostic value of sonography. AJR Am J Roentgenol 1998;171(4):1061–1065. DOI: 10.2214/ajr.171.4.9762997
Quinn SF, Erickson S, Black WC. Cystic ovarian teratomas: the sonographic appearance of the dermoid plug. Radiology 1985;155(2):477–478. DOI: 10.1148/radiology.155.2.3885313
Malde HM, Kedar RP, Chadha D, et al. Dermoid mesh: a sonographic sign of ovarian teratoma. AJR Am J Roentgenol 1992;159(6):1349–1350. DOI: 10.2214/ajr.159.6.1442421
Bronshtein M, Yoffe N, Brandes JM, et al. Hair as a sonographic marker of ovarian teratomas: Improved identification using transvaginal sonography and simulation model. J Clin Ultrasound 1991;19(6):351–355. DOI: 10.1002/jcu.1870190605
Kurjak A, Kupesic S, Babic MM, et al. Preoperative evaluation of cystic teratoma: what does color Doppler add? J Clin Ultrasound 1997;25(6):309–316. DOI: 10.1002/(sici)1097-0096(199707)25:6<309::aid-jcu4>3.0.co;2-g
Jeanty P, Besnard S, Arnold A, et al. Air-contrast sonohysterography as a first step assessment of tubal patency. J Ultrasound Med 2000;19(8):519–527. DOI: 10.7863/jum.2000.19.8.519
Holz K, Becker R, Schürmann R. Ultrasound in the investigation of tubal patency. A meta-analysis of three comparative studies of Echovist-200 including 1007 women. Zentralbl Gynakol 1997;119(8):366–373.
Exacoustos C, Zupi E, Carusotti C, et al. Hysterosalpingo-contrast sonography compared with hysterosalpingography and laparoscopic dye pertubation to evaluate tubal patency. J Am Assoc Gynecol Laparosc 2003;10(3):367–372. DOI: 10.1016/s1074-3804(05)60264-2
Chan CC, Ng EH, Tang OS, et al. Comparison of three-dimensional hysterosalpingo-contrast-sonography and diagnostic laparoscopy with chromopertubation in the assessment of tubal patency for the investigation of subfertility. Acta Obstet Gynecol Scand 2005;84(9):909–913. DOI: 10.1111/j.0001-6349.2005.00797.x
Teede HJ, Misso ML, Costello MF, et al. International evidence based guideline for assessment and management of polycystic ovarian syndrome 2018. Fertil Steril 2018;110(3):364–379. DOI: 10.1016/j.fertnstert.2018.05.004
Buckett WM, Bouzayeb R, Watkin KL, et al. Ovarian stromal echogenicity in women with normal and polycystic ovaries. Hum Reprod 1999;14(3): 618–621. DOI: 10.1093/humrep/14.3.618
Fulghesu AM, Angioni S, Frau E, et al. Ultrasound in polycystic ovary syndrome–the measuring of ovarian stroma and relationship with circulating androgens: results of a multicentric study. Hum Reprod 2007;22(9):2501–2508. DOI: 10.1093/humrep/dem202
Raine-Fenning NJ, Campbell BK, Clewes JS, et al. The reliability of virtual organ computer-aided analysis (VOCAL) for the semiquantification of ovarian, endometrial and subendometrial perfusion. Ultrasound Obstet Gynecol 2003;22(6):633–639. DOI: 10.1002/uog.923
Kyei-Mensah AA, LinTan S, Zaidi J, et al. Relationship of ovarian stromal volume to serum androgen concentrations in patients with polycystic ovary syndrome. Hum Reprod 1998;13(6):1437–1441. DOI: 10.1093/humrep/13.6.1437
Panchal SY, Nagori CB. Correlation of ovarian and stromal volumes to fasting and postprandial insulin levels in polycystic ovarian syndrome patients. Int J Infertil Fetal Med 2014;5(1):12–14. DOI: 10.5005/jp-journals-10016-1073
Kyei-Mensah A, Zaidi J, Pittrof R, et al. Transvaginal three-dimensional ultrasound: accuracy of follicular volume measurements. Fertil Steril 1996;65(2):371–376. PMID: 8566265.
Zaidi J, Barber J, Kyei-Mensah A, et al. Relationship of ovarian stromal blood flow at the baseline ultrasound scan to subsequent follicular response in an in vitro fertilization program. Obstet Gynecol 1996;88(5):779–784. DOI: 10.1016/0029-7844(96)00316-X
Merce LT, Barco MJ, Bau S, et al. Prediction of ovarian response and IVF/ICSI outcome by three-dimensional ultrasonography and power Doppler angiography. Eur J Obstet Gynecol Reprod Biol 2007;132(1):93–100. DOI: 10.1016/j.ejogrb.2006.07.051
Panchal SY, Nagori CB. Can 3D PD be a better tool for assessing the pre HCG follicle and endometrium? A randomized study of 500 cases. J Ultrasound Obstet Gynecol 2006;28(4):504. DOI: 10.1002/uog.3361
Kupesic S, Kurjak A. Predictors of IVF outcome by three-dimensional ultrasound. Hum Reprod 2002;17(4):950–955. DOI: 10.1093/humrep/17.4.950
Vlaisavljevic V, Reljic M, Gavric Lovrec V, et al. Measurement of perifollicular blood flow of the dominant preovulatory follicle using three-dimensional power Doppler. Ultrasound Obstet Gynecol 2003;22(5):520–526. DOI: 10.1002/uog.225
Merce LT, Barco MJ, Kupesic S, Kurjak A. 2D and 3D power doppler ultrasound from ovulation to implantationIn Kurjak A, Chervenak F (Eds): Textbook of perinatal medicine. London: Parthenon Publishing, 2005
Zaidi J, Campbell S, Pittrof R, et al. Endometrial thickness, morphology, vascular penetration and velocimetry in predicting implantation in an in vitro fertilization program. Ultrasound Obstet Gynecol 1995;6(3):191–198. DOI: 10.1046/j.1469-0705.1995.06030191.x
Raga F, Bonilla-Musoles F, Casan EM, et al. Assessment of endometrial volume by three-dimensional ultrasound prior to embryo transfer: clues to endometrial receptivity. Hum Reprod 1999;14(11):2851–2854. DOI: 10.1093/humrep/14.11.2851
Kupesic S, Bekavac I, Bjelos D, et al. Assessment of endometrial receptivity by transvaginal color Doppler and three-dimensional power Doppler ultrasonography in patients undergoing in vitro fertilization procedures. J Ultrasound Med 2001;20(2):125–134. DOI: 10.7863/jum.2001.20.2.125
Wu HM, Chiang CH, Huang HY, et al. Detection of the subendometrial vascularization flow index by three-dimensional ultrasound may be useful for predicting the pregnancy rate for patients undergoing in vitro fertilization-embryo transfer. Fertil Steril 2003;79(3):507–511. DOI: 10.1016/s0015-0282(02)04698-8
Oyesanya OA, Parsons JH, Collins WP. Total ovarian volume before human chorionic gonadotrophin administration for ovulation induction may predict the hyperstimulation syndrome. Hum Reprod 1995;10:3211–3212. DOI: 10.1093/oxfordjournals.humrep.a135890