Handbook of Infertility and Ultrasound for Practicing Gynecologists Chaitanya Nagori, Sonal Panchal
INDEX
Page numbers followed by b refer to box, f refer to figure, fc refer to flowchart, and t refer to table.
A
Abdomen 298, 314, 499
axial section of 312f
coronal section of 316f
transverse section of 313f
Abdominal abnormalities 330
Abdominal cavity 245
Abdominal circumference
measurement 438f
stomach section for 298
Abdominal diameter 441, 442
Abdominal ectopic pregnancy 286, 287f
Abdominal scan 203
Abnormal early pregnancy, evaluation of 279
Abortion 142
early missed 280
Abruption, chronic 436
Absent central hyperechoic 206f
Absent corpus callosum 382f
Abstinence 6
Achondroplasia 333, 334f
Acidemia 459
Acidosis 459
Acquired thrombophilia 150
Acquired uterine abnormalities 208, 505
Acrania 293, 294f, 323, 325, 326f
Active married life 4
Acupuncture 131
Adenomyomas 209
Adenomyosis 209, 213, 234, 506f
B-mode of 143f
uterus 214f
Adenosine triphosphate 447
Adnexa 195, 246
thickening of 195
Adnexal diseases 230
Adnexal lesions 230, 231
Adnexal malignancy, detection of 245t
Adnexal mass 285
Adrenal dysfunction 23
manifestation of 23
Adrenal glands 16
Adrenal hyperplasia, congenital 123
Adrenocorticotropic hormone 16
Agonists 33
Alcohol 120
bad effects of 120
Alloimmunity 154, 162
Alpha-fetoprotein 445
Alyce's forceps 69
American Fertility Society 138
American Thyroid Association 159
Amniotic band syndrome 334
Amniotic fluid index 317, 318, 439
assessment of 319f, 440f, 443
Amniotic membrane 291
Anastrozole 42
Androgen 38, 125
diffuses 56
Androstenedione 16
Anechoic myometrial cysts 213
Anemia 338
Anencephaly 323, 325
Aneuploidies 351
Angiomode 484
Angular pregnancy 504f
Antagonist 26
protocol 54
Antagonist-agonist protocol 55
Anteverted anteflexed uterus 189f
Anteverted retroflexed uterus 189f
Antiandrogenic properties 26
Antibodies, presence of 73
Anticytokine effect 145
Antiestrogenic agent 26
Antiestrogenic effect 29, 30
Antigen-receptor interactions 155
Anti-inflammatory drugs 126
Anti-müllerian hormone 17t, 18, 54, 55, 69, 114, 259
applications of 19
Antinuclear antibody 147, 148
Antioxidants 127, 128
dosage of 132
Antiphospholipid antibodies,
diagnosis of 146
syndrome 435
Antiphospholipid syndrome 145, 162
Antiserotonin agents 126
Antithyroid antibody 147
Antral follicle 17
arrangement of 254
in vitro fertility cycles 260
number of 254, 260
Antral follicle count 12, 48, 49, 69, 255, 260
assessment of 509
Aortic arch 298
Aortic end-diastolic flow, absent 453f
Aortic isthmus 457f
flow 455
Apert syndrome 366
Aplastic uterus 207
Arachnoid cyst 369, 370
Arginine 129
Aromatase 38
inhibitors 127
Artifacts 183
Artificial insemination, failed 63
Ascites 334
Aseptic technique 73
Aspirin 34, 147, 152
low dose 34
Assisted reproductive technology 5, 53, 90
protocols for 53
Asthenospermia 128
Atrioventricular septal defect 329, 329f
Atypical endometrium 253
Autocrine-paracrine mechanism 127
Autoimmune diseases 441
Autosomal recessive trait 150
B
Basal body temperature chart 87
Baseline scoring system 49t
Basic probe movements 186
Basic transvaginal sonography 173
Beak sign 231, 249f
Benzyl alcohol 90
Beta-human chorionic gonadotropin 245, 279, 322
Bicarbonate 75
Bicorporeal septate uterus 203, 204f
Bicorporeal uterus 140f, 141, 188, 202, 203, 205, 205f
complete 204f
Binocular diameter 307
Biophysical profile 443
role of 461
Biopsy attachment 185f
Biparietal diameter 300, 369, 375, 437, 441
Bird's nest appearance 235f
Bladder 298
exstrophy of 332
with dimple 207f
Blake's pouch cyst 372
Blastocyst transfer 51
Blood
flow 261
vessels 182f
Body mass index 40, 49, 106
Bones, short long 351
Bowel atresia 351
Brain development 387
Breast and ovarian cancer 30
Breast cancer, risk of 30
Broad ligament 245
fibroid 230, 247
Bromocriptine 11, 32
Butterfly sign 387
C
Caffeine 120
Calculating risk 353
Captopril 126
Cardiac abnormalities 294, 329, 338, 340
Cardiac activity 290, 291
Cardiac anomaly 352
Cardiac disease 435
Cardiovascular abnormalities 323
Carotenoids 131
Carpenter syndrome 366
Cavum septi pellucidi 372, 373f
Cavum septum pellucidum 300, 366, 369, 371
Cell-free fetal deoxyribonucleic acid 354
Central hyperechoic mucosa 242
Central nervous system 494
abnormalities of 362
Centrifuge machine 78
Cephalometric analysis 309
Cerebellar hypoplasia 372
Cerebellar transverse diameter 375
Cerebellum 305, 366, 371, 377
banana sign of 306, 377, 378f
Cerebral artery
Doppler, middle 449
middle 373, 374f, 447, 452f, 459
resistance, low middle 453f
Cerebral circulation 373, 373f
Cerebral hypoxia 453
Cerebral index 441
Cerebral vasculature 496f
study of 373
Cerebroplacental ratio 451
Cervical
anomalies 199
aplasia, unilateral 207
factor, counseling for 5
fibroid 227f
glands 191
incompetence 144
index 144
lesions 208, 225
malignancies 225, 506
mucosa 191
polyps 227f
pregnancy 285f
secretions 6
Cervix 29, 189, 191, 195
carcinoma 507f
normal 207
normal double 208f
single normal 208f
with septum 208f
Chaotic vascular architecture 239
Chest 498, 499f
Chocolate cyst 234
Chorioangioma 295, 295f
Chorionic tissue, abnormal 221
Chorionic villus sampling 357
Choroid plexus 368
cyst 301f, 348, 348f, 349t
Chromosomal abnormalities 152, 436
Chromosomal anomalies 337
fetal screening for 321
Chromosomal markers 334
Cilia, movements of 7
Cingulate gyrus 382
Circle of Willis 374, 374f, 380
Cirrhosis 472
Cisterna magna 305, 366, 371, 372, 377, 377f
depth of 375
Cleft lip 327, 328f, 491f
Cleft palate 323, 327, 328f, 491f
Clinical pregnancy rate 55
Clomiphene 26, 34, 166
failure patients 47
resistant patients 46
treatment, extended 31
Clomiphene citrate 26, 3235, 42, 45, 63, 107, 110, 122, 124
contraindications 27
cycles 13
dose of 28t, 166
indications of 26
mechanism of action 26
monitoring 28
resistant 39
risks of 30
side effects 29
treatment
alternatives 31
regimes 27
Club feet 334f, 501f
Coenzyme Q10 130
natural source of 130
Cogwheel sign 245
Collagen vascular disease 435
Color Doppler 177, 197, 212, 266, 277
aliasing in 183
Common testicular abnormalities 469
Conception rates 115f, 115t
Congenital anomalies 30
Congenital infections 351
Congenital uterine abnormalities 504
Conjoined twins 503
Contingent sequential screening 358
Corifollitropin alpha 56
Coronal plane 298, 314, 379, 385
Coronal spine 386f
Corpus callosum 368, 382
agenesis of 368f
Corpus luteal 278f
function 15
normal 88f
Corpus luteum 84, 232, 233, 233f, 246, 247f, 270, 271f, 277, 278f
rescue of 86
Cranial abnormalities 493
Cranial sutures 494f
Craniofacial variability index 496
Crown-rump length 335, 435,
measurement of 335f
Cryptorchidism 469
Cumulus oophorus 265f, 511f
Cyclopia 328
Cyproheptadine hydrochloric acid 126
Cystic atrophy 225f
Cystic hygroma 335, 340, 340f
milder cases of 340
Cystic lesion 249f
in prostate, large 478f
Cysts with internal echogenicities 231, 232
Cytochrome 38
Cytomegalovirus 351, 436
D
Dandy-Walker
malformation 372, 372f, 377
variation 372
Degenerated heterogeneous fibroid 211f
Dehydroandrosterone 16
Dehydroepiandrosterone 16
sulfate 15, 31
Density gradient methods 79
Deoxyribonucleic acid 127, 154
Dermoids 237, 238f, 508
Dexamethasone 31
Dextrocardia 294
Diabetes mellitus 159
severe 435
Diastematomyelia 387, 387f
Dichorionic diamniotic twins 287f, 503f
Diencephalon, development of 494
Diethylstilbestrol 139, 199f
Doppler angle 181
Doppler assessment, technique of 448
Doppler findings, obstetric management on 459
Doppler settings 177
making correct 179
Double bubble sign 331, 331f
Double intrauterine insemination 68
Down's fetuses 340
Down's syndrome 321, 342, 343, 349, 357, 358t
diagnosis of 342
Drugs 120
dosage of 131
Dual trigger 99
Ductus arch 298
Ductus venosus 341, 358, 459
flow 335, 341, 341f, 343
abnormal 341f
normal 454f, 456f
Duodenal atresia 323, 331, 352
Duodenum, dilated 500f
Dysmorphic uterus 139, 140, 199, 201f
Dysovulatory infertility 9, 26, 62
E
Ear
low placed 329f
short low placed 323, 328
Earle's balance
media 74
salt 75
Ebstein's anomaly 295f, 329, 329f
Echogenic cardiac focus 349
Echogenic mass 238f
Echogenic walls 247f
Ectopic pregnancies 7, 245, 247f, 280, 504
Effervescent progesterone vaginal tablets 92f
Eight weeks pregnancy 292f
Ejaculation, disorders of 123
Ejaculatory ducts 477
fibrosis of 479
Ellis-Van creveld syndrome 372
Embryo 7, 29, 278
transfer 252
Empiric therapy 124
Encephalocele 325f
Enclomiphene 26
proportion of 26
End-diastolic flow in umbilical artery, absent 452f
Endocrine
causes 158
workup 23
Endocrinological reports, normal 8
Endometrial biopsy 29, 87
Endometrial calcification 221, 223f
flecks of 217f
Endometrial carcinoma 221
Endometrial cavitiy 203, 213, 220
blood in 221f
fresh blood in 221f
one-third 203f
Endometrial fibroid 218, 219f
Endometrial grading 265
Endometrial hyperplasia 215, 218f
Endometrial lesions 208, 220
differential diagnosis of 217
Endometrial malignancy 221
Endometrial mass 224f
Endometrial metaplasia 223
Endometrial morphology 189
Endometrial pathologies 215, 220
Endometrial polyp 216, 218f
Endometrial stroma 225
Endometrial synechiea 143f
Endometrial thickness 278
Endometrial tuberculosis 7
Endometrioid tumors 237
Endometrioma 232, 234, 235f
diagnosis of 235
Endometriomyometrial junction 217f
thickness of 191
Endometriosis 157, 234
cases of 157
mild to moderate 62
Endometritis 215
acute 215, 216f
chronic 215
Endometrium 29, 189, 197, 215, 223, 265, 266f, 268, 270, 272
effects of 223
mature 264
normal multilayered 190f
persistently thin 215
poor 32
thick 216f
thin 217f
Endoscopy, normal 8
Epidermal growth factor 84
Epididymal ductal ectasia 477f
Epididymal lesions 473
Epididymis 467f
Epithelial tumors 237, 238
Equipment settings 173
Estimated fetal weight 438
Estradiol benzoate 88
Estrogen 26, 31, 38
therapy 472
European Society for Gynecological Endoscopy 139, 198
European Society of Human Reproduction and Embryology 139
F
Facial abnormalities 490
Facial angle, inferior 309
Facial anomalies 327
Fallopian tube 245, 282
inflammation of 242
Fallot's tetralogy 329
Feet, normal 501f
Female genital tract anomalies, classification of 139t
Femur length 316, 441, 442
Fertility 251
treatment, withholding 19
Fetal blood pressure, continuous rise in 446
Fetal cardiac output, continuous rise in 446
Fetal central nervous system 495
Fetal faces 490f
Fetal growth restriction 435
management of 435
Fetal head-brain, primary assessment of 363
Fetal heart rate 455
Fetal kidneys 333
Fetal medicine foundation 297, 322f, 335, 337
Fetal organ biometry 441
Fetal pole 290
Fetal spine, qualitative evaluation of 374
Fetal thrombophilia 151
Fetal well-being, assessment of 458
Fetus scratching ear 497f
Fibrinogen deficiency 150
Fibrinolytic factors 149
Fibroid 209, 213f, 476, 505, 506f
classification of 211
cystic degeneration of 211f
location of 212, 212f
three-dimensional ultrasound of 143f, 506f
typical of 218
Folate 127
Folic acid 128
Follicle
fertilization of 264
mature 262, 262f, 264
Follicle-stimulating hormone 11, 12f, 38, 45, 48f, 50, 51, 55, 64f, 107, 122, 125, 166, 252f, 256
Follicular atresia 257
Follicular cyst 232, 232f
Follicular growth, monitoring of 273
Follicular maturation 56
Follicular maturing drugs 159
Follicular maturity 13
Follicular ring sign 236, 237f
Follicular volume 512
Folliculogenesis 38
Follitropin alpha 53
Forearm, absent 502f
Frontomaxillary facial angle 308, 344, 344f
Frozen embryo transfer 94
Functional rudimentary horn 206f
G
G sperm 77
Galactorrhea 15, 32
Galen aneurysm, vein of 369, 370, 370f
Gastroschisis 332, 332f
Generalized cystic pattern 257
Genetic causes 152, 162
Genetic scan 323
Genital tract
infections 123
tuberculosis 479
Genital tuberculosis 479
Genitourinary anomalies 332
Genomic hybridization, comparative 152
Germ cell failure 22
Gestational age 297, 316, 435
small for 435
Gestational sac 281, 285, 285f, 288, 352
location of 282
measuring 288f
normally implanted 282f
volume 289f
Giant mitochondria 84
Glucocorticoids 31, 110, 148
Glutamine, substitution of 150
Glutathione 129
Gonadotropin 33, 42, 45, 47, 53, 58, 6365, 109, 110, 122
addition of metformin to 109
agonist 113
antagonist protocol 112
deficiency, severe 56
low doses of 106
specific bioactivity of 110, 110t
stimulated cycles 97
theory, two-cell-two 56
types of 52t
Gonadotropin therapy 46
indications of 46
principles of 46
Gonadotropin-releasing hormone 12f, 26, 54, 55, 65
agonist 13, 33, 98, 99, 505
and antagonist, role of 65
Granulosa cell 18
tumors 20
Great arteries, transposition of 330
Growth restriction intervention trial 458
Gynecological couch 184
H
Haematococcus pluvialis 128
Hairballs in cyst 238f
Hampered villous microcirculation 446
Hand, movements of 497f
Hands and fingers, normal 501f
Head
circumference 441, 443
qualitative
evaluation of 364
examination of 366, 375
shape and calvarium 366
Heart, four chamber of 298, 310, 310f
Helicobacter pylori 145
Hemiuterus 142, 188, 205
Hemivertebrae 386
Hemorrhagic cyst 232, 233, 246
Heparin 147
dose of 148
inhibits 152
mechanism of action of 148
Hepatitis C 145
Hernia, diaphragmatic 323, 330, 331f, 498
Heterogeneous myometrium 214f
Heterogeneous testis, small 471f
Hippocampal gyrus 373, 373f
Holoprosencephaly 294f, 324f
Hormone-dependent cancers 40
Human chorionic gonadotropin 32, 41, 47f, 48f, 55, 64f66f, 85, 86, 99, 112f, 124, 125, 152, 166, 264, 510
disadvantages of 95
supplementation 94, 160
trigger 98
Human immunodeficiency virus 82, 145
Human menopausal gonadotropin 22, 45, 52, 63, 110, 111, 123
Human serum albumin 74
Hydrocephalus 301f, 326
Hydrocephaly, severe 369
Hydrosalpinx 243
Hydrothorax 334
Hyperandrogenism 253
Hyperechoic bowel 350, 351f
Hyperhomocysteinemia 150
Hyperplasia 215
Hyperprolactinemia 22, 123, 160
Hyperstimulation, suspected risk of 14
Hypertension 441
chronic 435
pregnancy-induced 148, 435, 447f
Hypervolemia 339
Hypoechoic cervical glands 192f
Hypoechoic heterogeneous testis 472f
Hypogonadotropic hypogonadism 46, 56, 122
Hypopituitary disorders 472
Hypoplastic uterus 201f
Hypoproteinemia 338
Hypothalamo-pituitary
dysfunction 96
ovarian axis 11
testicular axis 12f
Hypothalamus 15, 26
Hypoxemia, stage of 450
I
Idiopathic infertility, treatment for 8
Idiopathic normogonadotropic oligozoospermia 125
Idiopathic oligozoospermia 125
Immature follicles 257
Immunization, active 155
Immunological causes 123, 436
In situ hybridization, multiplex fluorescence 152
In vitro fertilization 11, 18, 33, 41, 49, 62, 120, 509
counseling for 9
In vitro maturation 116
Inadequate corpus luteal function 272f
Inadequate trophoblastic invasion 446
Indomethacin 126
Infection 157, 436
Infertile couple
counseling of 3
hormonal assessment of 11
Infertile women, investigations for 11
Infertility 509
Infertility management 62, 166
backbone of 3
drugs 166
investigations 167
meaningless for 11
prescription 169
procedures 168
ultrasonography 169
Infertility treatment
assessment for 251
regular 5
Infrequent anomalies 207
Iniencephaly 323, 326, 326f
Innate immune system 154
Insemination, timing of 68
Insulin
lowering drugs 108
resistance 20
severe 20
Insulin-like growth factor 18, 38, 84, 114, 259
Intact hypoechoic endometriomyometrial junction 190f
Intensive luteal support 99
Intercourse, continuous unprotected 4
Internal carbohydrate complexity 53
International ovarian tumor analysis 230
Intracranial translucency 306f, 327, 346, 346f
Intracytoplasmic sperm injection 14, 75, 109, 120, 169
Intramuscular progesterone 90
Intraovarian cystic lesion 241f
Intraovarian lesion 231f
Intrauterine adhesions 144
Intrauterine contraceptive device 221
Intrauterine gestational sac 285
Intrauterine growth restriction 303, 332, 372, 460t
baby, history of 435
risk factors for 441
ultrasound diagnosis of 441
Intrauterine insemination 8, 27, 42, 47, 49, 62, 69, 73, 78, 112f, 121, 252, 510
counseling for 8
indications of 62
steps of 63
Intravenous immunoglobulin 148
Intravenous pyelography 138
Ishidori's regimen 167
Isoechoic walls 247f
Isomerism 330
J
Jejunal atresia 334
K
Ketotifen 126
Kidneys 298
Klinefelter's syndrome 472
L
L-acetylcarnitine 129
Laparoscopic ovarian drilling 114
Laparoscopic tubal ligation 8
Laparoscopic-assisted myomectomy 144
Last menstrual period 435
L-carnitine 129
Left ventricle, echogenic focus in 349f
Left ventricular outflow tract 298, 310
Leiomyosarcoma 209, 212
Lemon sign 378
Lemon skull 301f, 367f
sign 378f
Lenses 298
Lesions
benign 242t
malignant 242t
Letrozole 38, 42, 45, 65, 107, 108, 166
advantages of 39, 41
characteristics of 39
doses 40
indications 39
side effects 41
step-up protocol 41
stimulated cycle 97
therapy, extended 41
Leukemia inhibitory factor 84, 98, 155
Leuprolide acetate 54
Limb 298, 315
abnormalities 293, 499
body wall complex 334
reduction abnormalities 324, 333
Lip 298, 307
lower 308f
Lissencephaly, absence indicates 373
Localized fluid collection 195
Low birth weight 435
Low pulse repetition frequency 183f
Low resistance ovarian stromal flow 259f
Low-dose protocol, chronic 48, 65, 111
Lower limbs, fusion of 334
Low-molecular-weight heparin 147
Luteal gap 98
Luteal phase defect 27, 84, 159, 272, 272f, 273f
cause of 96
diagnosis of 87
pathophysiology of 85
Luteal phase estradiol 85
Luteal support, duration of 101
Luteinized unruptured follicle 232, 233, 234f, 271, 272f
Luteinizing hormone 11, 12f, 26, 38, 45, 56, 65, 106, 252f, 256
ceiling effect 57
releasing hormone 39
supplementation 56, 57
threshold 56
Lycopene 131
Lymphatic drainage, development of 338
M
Macroadenoma 15
Magicut 485f
Male infertility 467
laboratory investigations for 21
management of 22
medical management in 120, 121
ultrasonography in 465
Male subfertility 62
Marfan syndrome 366
Mass lesion 190, 195
Maxilla, plane of 307
Maxillary plane 297
Mayer-Rokitansky-Küster-Hauser syndrome 207
Meckel-Gruber syndrome 372
Meconium ileus 351
Mega cystitis 324
Megacystis 333f, 350
Meigs’ syndrome 236
Meiotic division 45
Meningocele 386f
Menstrual cycle 252f
phases of 191
Mesencephalon, development of 494
Metformin 33, 34, 109
after conception 109
alternatives 109
effectiveness of 109
therapy 20
Microadenoma 15
Micrognathia 323, 328, 328f
Microlithiasis 472
Midline vessels on Doppler 383f
Midluteal serum progesterone 14
Miscarriage 30
Misconception 6
Modern infertility practice 7
Modulating secretory transformation 84b
Motile sperms 73
Motility, decrease 79
Müllerian abnormalities 198
classification for 198, 200f
Müllerian duct 198, 205
abnormalities 138, 198, 199, 202
class U0 199
class U1 199
incidence of 198
incidence of 198
normal fusion of 202
Müllerian malformations 205
Multifollicular development 41
causes 26
Multiple anomaly syndromes 436
Multiple antral follicles 253, 254
Multiple follicles 14
Multiple gestation 287f, 436
early detection of 279, 286
Multiple pregnancy 30, 65
early 280
Myocardial performance index 461
Myomas 142
Myometrial calcification 217f
Myometrial cysts 215
Myometrial lesions 208
Myometrium 190, 209, 213, 215
anterior 193
homogenicity of 190
innermost layer of 189
posterior 193
N
Nabothian cysts 225, 227f
Nasal bone 298, 327, 336, 342, 343, 343f, 346f
length 308, 335
Natural cycle, luteal support in 96
Negative predictive value 235
Neural tube anomalies 324
Neuromuscular defects 338
Nonapoptotic sperm selection 82
Non-assisted reproductive technology 167
Non-hyperactivated sperms 79f
Non-in vitro fertilization 95
Nonseptated clear cysts 231
Noonan's syndrome 340
Nostrils 308f
Nuchal fold thickness 339
Nuchal scan 488
Nuchal translucency 327, 335, 338, 339, 343, 346f, 354, 489f
causes of increased 337
measuring 335
Nuclear channel system 84
O
Occupational and environmental hazards 120
Ocular abnormalities 323, 328
Oligoasthenospermia, antioxidants for 128t
Oligoasthenoteratozoospermia 21
Oligoasthenozoospermia, role in 129
Oligomenorrhea 160
Oligospermia 128
Oligozoospermia 124b
medical management of 120
Omega-3 fatty acids 131
Omphalocele 313f, 324, 331, 331f
Oocyte numbers, reduced 12
Open spinal canal 386
defect 386f, 387f
Optimal fertility 17
Oral contraceptive 100
treatment with 34
Oral sustained-release tablets 89
Orchitis 472, 472f
Outpatient department 3
Ovarian area 258
Ovarian artery perfusion 273
Ovarian cancer 242t
Ovarian causes, counseling for 8
Ovarian cysts 507
Ovarian drilling 113, 168
advantage of 113
indications of 113
newer methods for 115
Ovarian ectopic pregnancy 246, 285, 286f
Ovarian fibroma 236f
Ovarian follicular development 26
Ovarian hyperstimulation syndrome 14, 30, 47, 55
controlled 19, 40, 47
high risk of 106
incidence of 65
risk of 41, 168
Ovarian lesions 230, 231, 507
classification of 231
Ovarian response 56t
predictors of 55
Ovarian stimulation, controlled 18, 45, 55
Ovarian stroma 197
resistance index 48
Ovarian stromal flow, measurement of 261
Ovarian suppression, assess 13
Ovarian torsion 237f
Ovarian volume 48, 258, 512
Ovaries 29, 203, 245
baseline scan of 252
enlarged 253
simple cyst of 232
three-dimensional ultrasound of 258f
Ovulation
mechanism of induction of 38
physiology of 46
Ovum 29
donation 69
P
Panhypopituitarism 22
Paramesonephric ducts 198
Paraovarian cyst 230, 247, 248, 249f
Parental lymphocyte immunization 156
Partial mole 221
Partial septum-subseptate uterus 202
Peak systolic velocity 49, 66f, 277, 450
Pedunculated fibromas 236
Pelvic inflammatory disease 242, 244f
Pelvic mass 188
Pelvic organs
anatomical relationship of 175
orientation of 184
sonography of 184
Pelvis 205f
Penicillin 74, 75
Pentalogy of cantrell 329, 330
Pentoxifylline 129
Peripheral cystic pattern 257, 257f
Peritoneal ectopic pregnancy 286
Peritoneal inclusion cyst 230, 247, 248, 248f
Periurethral cysts 478
Placenta 499
anterior 318f
Placental apoptosis, induction of 145
Placental bleeding 436
Placental growth factor, low 445
Placental infarct 435
Placental infections 436
Placental mosaicism, confined 436
Placental perfusion, reduced 446
Placental vasculature on angiomode, normal 484f
Placental vessels, widening of 446
Placental villi, continuous maturation of 446
Platyspondyly 387
Pneumonia 145
Polycystic ovarian syndrome 26, 39, 47, 65, 106, 112f, 160, 163, 253, 256, 509
diagnosis of 11, 258
evolution of 256
principles of treatment 106
treatment modalities in 106
Polycystic ovary 9, 18, 48, 169, 251, 253, 255f, 257f, 510f
diagnosis of 12
three-dimensional volume of 255f
Polymerase chain reaction 7
Polyp 144, 216, 505
Porencephalic cyst 369, 370, 370f
Positive predictive value 235
Postcoital test 5
normal 6
Postcurettage endometrial collection 220
Postmenopausal bleeding 221
Pouch of Douglas 271
Power Doppler 178
Predominant hyperechoic stroma 257
Pregnancy
abnormal first-trimester 277
abnormal location of 284
confirmation of 279
first trimester of 277
growth of 287
location of 279
monitoring 154
normal 154
normal first-trimester 277
progress of 279, 287
six weeks 291f
twelve weeks 293f
Pregnancy loss 160
anatomical causes 138
in thrombophilia, pathophysiology of 150
recurrent 137, 153, 157, 161
Pregnancy-associated plasma protein-A 322
Pre-human chorionic gonadotropin endometrial parameters 67f
Preimplantation genetic
diagnosis, role of 153
screening 161
Prenatal tests, noninvasive 354
Preovulation luteinizing hormone 84
Preovulatory scan 251, 261, 509
Progesterone 89, 93, 113, 159
gel 93
in luteal phase, role of 84b
induced blocking factor 159
injectable 90
micronized 34
natural micronized 91b
preparations 89
production of 85fc
resistance 100
vaginal effervescent tablets 92
Prostatic cysts 478f
Prostatic inflammation 479
Protein
C deficiency 149
S deficiency 149
Prothrombotic states 435
Pseudo sac 279t, 280f
Pulmonary atresia 330
Pulmonary hypoplasia 330
Pulsatility index 259, 374
Pulse repetition frequency 179, 448, 468
higher 180f
Pulsed wave Doppler 179
Punctures, number of 115
Puresperm 81
R
Radial aplasia 333
Recombinant deoxyribonucleic acid 49
Recombinant follicle-stimulating hormone 49, 50, 52, 53, 56, 111, 123
types of 52
Recombinant human luteinizing hormone 57, 58
Recombinant luteinizing hormone 57
Rectal placement 184
Rectovaginal septum 234
Recurrent pregnancy loss, causes of 137
Region of interest 179
Renal disease 435
Renal pelvic diameter, assessment of 313f
Renal pelvis 313f
plane 312
Renal pyelectasis 350, 350f
Residual endometrial cavity 280f
Resistance index 212
Retroflexed fundus 188
Retrograde ejaculation 22, 82
Retroverted anteflexed uterus 189f
Retroverted retroflexed uterus 189f
Rhombencephalon 388f
development of 494
Ribonucleoprotein 154
Right ventricular outflow tract 298, 310, 311f
Rim sign 231
Robert syndrome 366
Rokitansky's tubercle, large 238f
Rubin's test 4
Rupture of follicle, physiology of 68
S
Sacrum
transverse 298
section of 314f
Sagittal leg and foot 298
Saline infusion sonohysterography 198
Salpingitis 245
Satisfactory fertility 17
Scandinavian method 81
Scar tissues 190
Scrotal ultrasound 465
Secretory endometrial flow, normal 88f
Secretory endometrium 271f, 278f
Secretory scan 251, 270
Selenium 129
Semen
analysis 121
counseling for 4
normal 8
collection jar 74
normal 121t
parameters, normal 121t
preparation 63, 69
complications 70
sample, collection of 73
Seminal plasma 75
Seminal vesicle 476
cysts 476
Seminal vesiculitis 476
Septal defect 295f
Septate uterus 140f, 141, 202
Septo-optic dysplasia 369
Serosa 190
anterior 193
posterior 193
Serum
albumin 75
anti-müllerian hormone 17
cortisol 23
dehydroepiandrosterone sulfate 16
estradiol 13
follicle-stimulating hormone 11
luteinizing hormone 13
progesterone 14, 87, 159
prolactin 15, 20, 23
testosterone 16, 23
thyroid-stimulation hormone 20
Sex hormone-binding globulin 23, 130
Shirodkar's operation 145
Simple cyst 232
Single-strand annealing 154
Single-stranded binding 154
Singleton pregnancies 33
Sirenomelia 334
Situs inversus 294
Skeletal abnormalities 333
Skeletal dysplasias 436
Sliding organ sign 195
Smoking 120
and poor nutrition 435
bad effects of 120
Smoothness of contour 190
Sodium
bicarbonate 74
pyruvate 74
Solid lesions 231, 236
Sonohysterography 138, 220
Speckle reduction imaging 177, 178f
Sperm 8
abnormal 5
capacitation 76
count 5
damage 73
morphology, abnormal 160
motility 130
lower 73
preparation 73, 74
laboratory 74
media 74, 77, 77t
methods 75
Spermatid arrest 22
Spermatogonia arrest 22
Spermatozoa 6, 69
motility of 128
Spina bifida 323, 326
occulta 386
with hydrocephalus 327f
Spinal abnormalities 497
Spinal canal defects 387f
Spinal defects 295
Spine 298
abnormalities, multiple 387f
coronal planes of 384f
coronal section of 315f
longitudinal 375f
section of 375, 385f
normal 498f
qualitative evaluation of 364
three-dimensional ultrasound of 384f
vertebra 498f
Spiral arteries 197, 266
Spiral vessels, normal 213
Split ejaculation 74
Spontaneous abortion 157
Steelman-Pohley bioassay 53
Stepwise sequential screening 358
Stimulate follicular estradiol 26
Stimulates hypothalamus 45
Stomach, dilated 500f
Strassman's operation 142
Strawberry-shaped skull 348, 348f, 367f
Streptomycin 75
Streptopenicillin 75
Stress, role of 158
Stricture urethra 479
Stromal abundance 253
Stromal area 258
Stromal predominance 254
Stromal volume 258
Subclavian artery, aberrant right 346, 355
Subcutaneous aqueous progesterone 90
Subendometrial vascularity 216f
Submucous fibroid 213
Submucous myomas 142
Subnuclear glycogen deposit 84
Superovulation 63
Suprasperm 80
method for 80
Swim-up from ejaculate 76, 77
Sylvian fissure 374
Sylvius, aqueduct of 336
Synechiae 219, 506
Synthetic progesterones 93
Synthetic serum replacement 74
T
Tamoxifen 125, 223
effects of 223
Tender loving care, role of 158
Teratogens 436
Testicular atrophy 470
Testicular infarction 472
Testicular neoplasms 472
Testicular sperm extraction 124
Testicular torsion 472
Testicular trauma 473
Testis, normal 467f
Testosterone 16, 125
deficiency, isolated 123
high 21
low 22
normal 21
sources of 16t
undecanoate 125
Thermal balloon ablation 216
Thorax 298
Thromboelastography 149
Thrombophilia 148, 150, 162, 163
screening for 151
Thrombosis 150
Thumb, infolding of 502f
Thyroid 158
dysfunction 22
function 158
tests 20
Timor-Tritsch sign 195
Tissue
hormones 126
interface, maintenance of 190
Total motile sperm 62
Total ovarian stromal area 260
Total ovarian volume 260
Total oxyradical scavenging capacity 130
Traditional Chinese herbal medicine 131
Transabdominal route 184
Transabdominal scan 195
Transcaudate coronal plane 380f
Transcerebellar plane 371f, 381f
Transdermal progesterone 90
Transforming growth factor 17, 84
Transfrontal coronal plane 379f
Transfrontal plane 297, 306, 379
Transrectal route 184
Transrectal ultrasound 473
Transthalamic coronal plane 380f
Transthalamic plane 297, 300, 364, 372, 380
Transvaginal route 184
Transvaginal scan 184, 188f
interpretation of 187
method of 363
Transvaginal sonography 198, 251, 277
Tricuspid flow, normal 345f
Tricuspid regurgitation 344, 346
Trimester scan, second 297
Triploidy 338
Trisomy 18 303, 321, 333, 338
Trisomy 21 321, 354t
True gestational sac 279f
True sac 279t
Tubal ectopic pregnancy 247f, 285, 286f
Tubal factor, counseling for 7
Tubal inflammation 245t
Tubal lesions 230, 242
Tubal ligation 8
Tuberculosis 215
Tuberculous endometritis 215
Tuberculous orchitis 479
Tubo-ovarian
abscess 245
complex 245
lesions 230
Tumors 239, 334
malignant 239
Turner's syndrome 332, 338
Twin-to-twin transfusion 436
Typical bird's nest appearance 235
Typical golf-club appearance 316
U
Umbilical artery 449f, 454f, 458
Doppler 448
flow 320
normal 445
single 352f
Umbilical cord 312, 317
abnormalities 351
cyst 296f
insertion 298, 312
placental attachment of 317
Umbilical hypoxemia 446
Undescended testis 469
Unexplained infertility 8, 27
trial 64
Unicornuate uterus 140f, 142
Uniparental disomies 332
Unprotected intercourse 4
Upper lip 308f
Urinary follicle-stimulating hormone 50, 52, 56
Urinary tract infection 145
Uterine abnormalities 198, 199f
Uterine aplasia 207f
Uterine artery 195, 212, 270, 445
anatomy of 448f
Doppler 448
flow 268f, 444f
high resistance 259f
spectral Doppler of 320f
Uterine blood flow 273
Uterine cornu 245
Uterine diseases, ultrasound in 198
Uterine factor, counseling for 7
Uterine malignancies 506
Uterine natural killer cells 155
Uterine pass effect, first 91f
Uterine pathologies 198
Uterine scar 225
Uterine vasodilatation, absence of 446
Uterine vessels, entry of 191
Uterocervical length 261f
physiological 192
Uteroplacental dysfunction 435
Uterus 184, 188, 195, 206, 213, 245, 261
abnormality of 188
aplasia 207
infantalis 140, 200
layer of 190
normal 191f, 199, 201f
partial bicorporeal 203, 204f
section of 193f
systematic assessment of 189
thickness of 193
T-shaped 139, 140, 199, 201f
V
Vaginal absorption 92f
Vaginal anomalies 199
Vaginal aplasia 207
Vaginal progesterone 90, 101
rings 93
Vaginal suppositories 90
Varicocele 22, 466
correction 132
ultrasound grading of 470t
Vas deferens 474
congenital absence of 473
Vascular endothelial growth factor 18, 84, 114, 259
Vascularity flow index 509
Vena cava, inferior 294, 453, 466
Venous congestion 338
Venous Doppler, abnormal 459
Ventricular atrium 303, 375, 376
Vermis, absent inferior 372f
Vesicular mole 221, 295
Vessel compliance, continuous changes in 446
Virtual organ computer-aided analysis 485
Vitamin
B12 128
C 127, 128
D 130
E 127, 128
Volume transvaginal probe 185f
W
Weak cesarean scar 226f
White blood cell 73
Y
Y-chromosome deletion 472
Yolk sac 288, 288f
large 290f
solid 290f
thick-walled 290f
tiny 290f
Z
Zinc 125
Zuclomiphene 26
proportion of 26
Zygoma 336
×
Chapter Notes

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Handbook of INFERTILITY AND ULTRASOUND for Practicing Gynecologists
Handbook of INFERTILITY AND ULTRASOUND for Practicing Gynecologists
Second Edition
Chaitanya Nagori MD DGO Director Dr Nagori's Institute for Infertility and IVF Ahmedabad, Gujarat, India Sonal Panchal MD Ultrasound Consultant Dr Nagori's Institute for Infertility and IVF Ahmedabad, Gujarat, India
Jaypee Brothers Medical Publishers (P) Ltd
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© 2021, Jaypee Brothers Medical Publishers
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Handbook of Infertility and Ultrasound for Practicing Gynecologists
First Edition: 2015
Second Edition: 2021
9789390020768
Printed at
Preface to the Second Edition
The obstetrician and gynecologist have to deal with infertility patients and also has to use ultrasound for one's own patients. But unfortunately the knowledge of infertility and ultrasound is insufficient as these are the two aspects of gynecologists’ practice to which they are not much exposed during their studies. The information available in big books of infertility and ultrasound is so wide that it is not possible for a practicing obstetrician and gynecologist to spare that time. We decided so, to write a book, that is handy, to the point, includes practical tips; and makes the gynecologist confident when dealing with a patient with infertility or doing an ultrasound scan, Handbook of Infertility and Ultrasound for Practicing Gynecologists as the first stepping stone to successful infertility and ultrasound practice.
First edition of this book has proved its worth as a quick guide for an Obstetrician and Gynecologist for their infertility patients and ultrasound scans. We here present the second edition of this book. We have tried to include all the new updates in every topic of this book, and still maintain it basic purpose to present to the point and practical information with tips and tricks to help in day-to-day practice.
Chaitanya Nagori
Sonal Panchal
Preface to the First Edition
We have been into infertility and ultrasound practice since more than two decades now and have seen more than 13,000 to 14,000 cases so far. Both learning and teaching has remained our passion for all our lives. It is not feasible for a busy gynecologist to go through lots of books with elaborate descriptions to treat their infertility patients.
We thought, today when we have a lot of experiences to share with you all that can be of help, we should take an opportunity to put it into words. We have tried to make the book short, precise and to the point, so that it can be used as a quick reference for all our friends, colleagues and students. We have tried to include the common topics which may be of help to a practicing gynecologist for infertility treatment and ultrasound. Though we have tried to make it as practical as possible, we have also tried to put the explanations, wherever required so that it becomes easy to digest and apply.
We hope this will be of great help to you all.
Chaitanya Nagori
Sonal Panchal