89 © Springer International Publishing AG, part of Springer Nature 2018 D. T. Carrell et al. (eds.), Emerging Topics in Reproduction, https://doi.org/10.1007/978-3-319-90823-6_6 Chapter 6 Advanced Imaging Techniques Used in the Infertile Female Erica Boiman Johnstone and Jeffrey Dee Olpin 6.1 Uterine Imaging Uterine factor infertility comprises a small portion of infertility diagnoses. Uterine abnormalities that may impact fertility and pregnancy outcomes include congenital uterine anomalies, uterine leiomyomata, adenomyosis, endometrial polyps, and uterine synechiae. No single imaging modality is optimal for evaluating all of these, and when there is a fnding of concern, multiple imaging tests may be required to ascertain the correct diagnosis and determine optimal management. 6.1.1 Uterine Anomalies The uterus and fallopian tubes are formed in utero by fusion of the bilateral Mullerian ducts, followed by canalization and resorption of the septum between these two tubes, under the infuence of the HOX family of genes [1]. Approximately 5.5% of women have an anomaly of the formation of the uterus, and thus these are among the most common congenital anomalies [2]. There is wide variability among anom- alous uteri, as well as varying impact on reproduction and options for treatment. Multiple classifcation systems for uterine anomalies have been developed over the past 40 years [3–7], with increasing emphasis on objective imaging fndings for classifcation. It is vital to correctly classify each uterine anomaly in order to coun- sel a woman about her risks and select appropriate candidates for surgery. In E. B. Johnstone, MD, MHS (*) Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, UT, USA e-mail: Erica.johnstone@hsc.utah.edu J. D. Olpin, MD Department of Radiology, University of Utah, Salt Lake City, UT, USA