| Three-dimensional saline infusion contrast sonography. Two-dimensional ultrasound had shown a persistently thick endometrium despite several weeks of pituitary suppression prior IVF treatment and saline infusion sonography has proven unhelpful simply confirming a thick endometrium despite very low serum oestradiol levels. A three-dimensional acquisition was undertaken therefore both before (Fig. 9a) and during the instillation of saline (Fig. 9b) and subsequently analysed off-line to reduce the amount of saline used and overall time needed for the examination. A large sub-mucosal leiomyoma with a broad base was seen originating from the left posterior aspect of the uterus that almost entirely occupied the cavity (Fig. 9b). This allowed the cancellation of the planned IVF treatment with the patient continuing her 'down-regulation' medication for a further two-months at which stage the fibroid was removed transcervically using a modified operative hysteroscope. |
