title: ACR appropriateness Criteria® infertility.
abstract: Appropriate imaging for women undergoing infertility workup depends upon the clinician's suspicion for potential causes of infertility. Transvaginal US is the preferred modality to assess the ovaries for features of polycystic ovary syndrome (PCOS), the leading cause of anovulatory infertility. For women who have a history or clinical suspicion of endometriosis, which affects at least one third of women with infertility, both MRI and pelvic US can provide valuable information. If tubal occlusion is suspected, whether due to endometriosis, previous pelvic inflammatory disease, or other cause, hysterosalpingogram (HSG) is the preferred method of evaluation. To assess for anatomic causes of recurrent pregnancy loss (RPL) such as Müllerian anomalies, synechiae, and leiomyomas, saline infusion sonohysterography, MRI and 3-D US are most appropriate. Up to 10% of women suffering recurrent pregnancy loss have a congenital Müllerian anomaly. When assessment of the pituitary gland is indicated, MRI is the imaging exam of choice.The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed every three years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances where evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment.
authors.affiliation: *Mayo Clinic, Rochester, Minnesota; †Rambam Healthcare Campus, Haifa, Israel; ‡Sunnybrook Health Sciences Centre, Bayview Campus, Toronto, Ontario, Canada; §University of Texas MD Anderson Cancer Center, Houston, Texas; ∥Massachusetts General Hospital, Boston Massachusetts; ¶Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire; #George Washington University Hospital, Washington, District of Columbia; **Thomas Jefferson University Hospital, Philadelphia, Pennsylvania; ††The Old Vicarage. Worcester Park, United Kingdom; ‡‡Massachusetts General Hospital, Boston Massachusetts; §§Memorial Sloan Kettering Cancer Center, New York, New York; ∥∥Brigham & Women's Hospital, Boston, Massachusetts, American College of Obstetrics and Gynecology; ¶¶Mallinckrodt Institute of Radiology, St. Louis, Missouri; ##Columbia University, New York, New York, American College of Obstetrics and Gynecology; ***University of Maryland School of Medicine, Baltimore, Maryland; and †††Valley Hospital, Ridgewood, New Jersey, American College of Obstetrics and Gynecology.
authors.forename: Darci J
authors.initials: DJ
authors.lastname: Wall
authors.forename: Marcia C
authors.initials: MC
authors.lastname: Javitt
authors.forename: Phyllis
authors.initials: P
authors.lastname: Glanc
authors.forename: Priyadarshani R
authors.initials: PR
authors.lastname: Bhosale
authors.forename: Mukesh G
authors.initials: MG
authors.lastname: Harisinghani
authors.forename: Robert D
authors.initials: RD
authors.lastname: Harris
authors.forename: Nadia J
authors.initials: NJ
authors.lastname: Khati
authors.forename: Donald G
authors.initials: DG
authors.lastname: Mitchell
authors.forename: David A
authors.initials: DA
authors.lastname: Nyberg
authors.forename: Pari V
authors.initials: PV
authors.lastname: Pandharipande
authors.forename: Harpreet K
authors.initials: HK
authors.lastname: Pannu
authors.forename: Thomas D
authors.initials: TD
authors.lastname: Shipp
authors.forename: Cary Lynn
authors.initials: CL
authors.lastname: Siegel
authors.forename: Lynn
authors.initials: L
authors.lastname: Simpson
authors.forename: Jade J
authors.initials: JJ
authors.lastname: Wong-You-Cheong
authors.forename: Carolyn M
authors.initials: CM
authors.lastname: Zelop
mesh_terms: D003952:Diagnostic Imaging / Q000592:standards*; D004715:Endometriosis / Q000150:complications / Q000175:diagnosis*; D005184:Fallopian Tube Diseases / Q000150:complications / Q000175:diagnosis*; D005260:Female; D006801:Humans; D007247:Infertility, Female / Q000175:diagnosis* / Q000209:etiology; D011085:Polycystic Ovary Syndrome / Q000150:complications / Q000175:diagnosis*; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D011871:Radiology / Q000592:standards; D018456:Reproductive Medicine / Q000592:standards; D014481:United States