Infertility affects approximately 13-15% of couples globally and is diagnosed when a couple fails to conceive after one year of regular, unprotected intercourse. This condition represents both clinical and social challenges, with several pelvic disorders contributing to female infertility. Among these are premature ovarian insufficiency, polycystic ovarian syndrome (PCOS), pelvic inflammatory disease (PID), endometriosis, fibroids, endometrial polyps, Müllerian duct anomalies (MDA), and adenomiosis.

Imaging techniques are critical for diagnosing infertility-related pathologies. Hysterosalpingography (HSG) is typically used to evaluate fallopian tube patency, followed by transvaginal ultrasound (TV-US), which provides detailed images of the uterus and adnexa. However, MRI is increasingly recognised for its superior soft tissue contrast, larger field of view, and greater consistency compared to ultrasound. Importantly, MRI is non-invasive and avoids ionising radiation, making it highly suitable for women of reproductive age (3, 7).

MRI Protocol

To achieve optimal imaging, minimising motion artefacts is essential. This is typically done by administering an antiperistaltic agent before the examination. A surface phased-array coil is used to improve image quality. T2-weighted images are obtained in all three planes to assess pelvic structures, while T1-weighted fat-saturated images help identify hemorrhagic adnexal masses or endometriotic deposits. Intravenous contrast is used selectively in cases such as PID or to assess fibroid viability and adnexal masses.