Infertility

FIG. 3.81. Diffuse adenomyosis. Sagittal T2-weighted image through uterus demonstrates thickened, indistinct junctional zone (<italic>arrows</bold>).

<bold>FIGURE 2.17 A, B:</bold> Close-up view of adenomyosis of the uterine fundus. This is diverticulosis of the uterine wall (<italic>arrows</bold> point to diverticular holes). <italic>V</bold> points to enlarged vessels. <bold>C:</bold> Associated with diverticular adenomyosis are enlarged, thin-walled surface vessels that account for increased uterine bleeding at the time of menses.

<bold>FIGURE 5.3</bold> Adenomyosis, foci of endometrial glands and stroma deep within the myometrium, distort the uterine wall. (10×, hematoxylin and eosin.)

<bold>FIGURE 5.4</bold> This gross photograph of a bisected supracervical hysterectomy specimen exhibits irregular thickening of the myometrium, characteristic of adenomyosis. Multiple deep myometrial foci of dark blue discoloration mark the sites of adenomyosis (<italic>long white arrows</bold>). The short black arrow indicates a small leiomyoma.

<bold>FIGURE 18.27</bold><bold>A</bold> and <bold>B:</bold> Hysterograms show direct signs of adenomyosis. The contrast medium has injected numerous diverticula.

<bold>FIGURE 22.40</bold> A: Endometrial atrophy with adhesions at the fundus of the uterus and old adenomyosis. B: Large diverticulum of adenomyosis just below the uterine fundus.

<bold>FIG. 28.8.</bold>Pelvic pain. A: Composite transvaginal sonogram showing enlarged left ovary (top right and bottom left) without flow and associated with a paraovarian cyst in left adnexa (lower right). The right ovary (top left) was normal, showing intraparenchymal flow. The left adnexa was found to be twisted three times and was surgically untwisted with good result. See color figure 28.8A. B: Doppler sonogram of enlarged left ovary containing venous flow. This finding suggest...

<bold>FIG. 28.10.</bold>Infertility. A: Mature follicle (between cursors) containing a small protrusion from the posterior wall representing the cumulus oophorus. B: Image taken during follicular aspiration showing echogenic needle tip within deflating mature follicle. C: Classic appearance of ovary seen in women with polycystic ovarian syndrome (’Â_string of pearls’).

<bold>FIG. 28.10.</bold>Infertility. A: Mature follicle (between cursors) containing a small protrusion from the posterior wall representing the cumulus oophorus. B: Image taken during follicular aspiration showing echogenic needle tip within deflating mature follicle. C: Classic appearance of ovary seen in women with polycystic ovarian syndrome (’Â_string of pearls’).

<bold>FIG. 28.10.</bold>Infertility. A: Mature follicle (between cursors) containing a small protrusion from the posterior wall representing the cumulus oophorus. B: Image taken during follicular aspiration showing echogenic needle tip within deflating mature follicle. C: Classic appearance of ovary seen in women with polycystic ovarian syndrome ("string of pearls").

Adenomyosis. A microscopic view shows an endometrial gland and stroma in the myometrium.

<bold>Fig GU 41-4. Diffuse uterine adenomyosis.</bold> Sagittal T2-weighted image demonstrates an enlarged uterus with thickening of the myometrium and diffuse low signal intensity throughout. The junctional zone is obliterated.⁴⁴

<bold>Figure 6.67 Polycystic ovarian disease.</bold> Both ovaries are enlarged and contain multiple subcortical follicle cysts.

<bold>FIG. 34.4.</bold>The ovaries in polycystic ovary syndrome shown in a woman with polycystic ovary syndrome at laparotomy. Note the large size of the ovaries, relative to the uterus, with a smooth ovarian capsule without evidence of ovulatory events.

<bold>Figure 37.3.</bold> A mechanism for polycystic ovarian syndrome proposed by Yen. LH = luteinizing hormone; LRF = luteinizing-releasing factor.

Polycystic Ovarian Syndrome Labeled

Polycystic disease of the ovary. Cut sections of an ovary show numerous cysts embedded in a sclerotic stroma.