Publication:

Three-dimensional follicular assessment: a review of technique and indications

Follicular maturity assessment and tracking are employed to ascertain mature oocytes’ presence and assess the response to ovarian stimulation. This step is crucial to ensure successful outcomes during assisted reproductive techniques. Currently, two-dimensional (2-D) transvaginal ultrasound is performed to monitor follicle growth and determine the optimal time for administration of human chorionic gonadotropin (hCG) hormone. However, the accurate follicle size, count, and multi-follicle maturity assessment require significant expertise and negligible inter-observer variations to maintain the reliability and validity of the measurements. 2-D ultrasound allows only an approximation of the actual follicular volume; therefore, it cannot be used to define standards for follicular maturity assessment. With the improvement of ultrasonography imaging technologies and the supporting software, it is now possible to acquire three-dimensional data sets and perform precise estimation of absolute dimensions, volumes, and mean dimensions of even complex structured follicles. This paper aimed to provide an in-depth review of the use of 3D ultrasound (3D-US) in reproductive medicine and combines an overview of the technique of performing a 3D-US for a fast, valid, objective, and reliable follicular assessment.