Secondary infertility in women: radiologic evaluation

Female infertility is a commonly encountered problem that presently accounts for a significant percentage of women seeking gynecologic services. While primary infertility is defined as the inability to conceive or carry a pregnancy successfully to full term, secondary infertility is defined as difficulty in conceiving after already having previously conceived (either carrying a pregnancy to term or a miscarriage). The causes of both primary and secondary female infertility are varied, and include various disorders involving the fallopian tubes, ovaries, uterus, cervix, and peritoneum. Imaging has become an essential tool in the workup of female infertility. Various imaging modalities are commonly employed to evaluate the female reproductive tract. Hysterosalpingography is typically performed as a baseline imaging study in the workup of female infertility. Ultrasound and pelvic magnetic resonance imaging studies are likewise routinely utilized to aid in the diagnosis of female infertility. The appropriate selection of imaging modalities is essential in establishing the etiology of female infertility in a timely, efficient, and cost-effective manner.