Transvaginal Ultrasound

A transvaginal ultrasound examination is an exam carried out, as the name suggests, via the vagina. It is used as a way of checking for physical causes of infertility within a woman's reproductive system. Because a transvaginal ultrasound is not a surgical procedure, it's one of the most common fertility tests for women who are having difficulty getting pregnant.

How It Works

A specially-shaped probe (also called a transducer) is inserted into the patient's vagina. The probe is covered with lubricant and a condom, and very rarely causes any discomfort. Via this probe, high-frequency sound waves moving at various speeds pass through the reproductive organs and the tissue inside the uterus, etc. These waves travel back to a detector which converts the waves into images of the organs. The images are viewed on a screen by the person carrying out the ultrasound exam. In this way, the organs are checked for any abnormalities which may be causing fertility problems.

What The Exam May Find

During a transvaginal ultrasound exam, a number of problems may (or may not) be detected which could be the root cause of the patient's failure to get pregnant. However, in some cases, physical defects in the reproductive system may be too small to show up on an ultrasound exam.

The exam will focus on:

The ovaries - are they correctly positioned? Are they abnormally large? Do they have an unusual structure? Are there any signs of ovarian conditions such as PCOS, which are linked to infertility? Are there any adhesions (attachments) to other organs which could be impeding normal ovarian function? Is there any sign of scarring or of cysts growing on the ovaries?

The fallopian tubes - the fallopian tubes can be affected by twisting and scarring and also by excess growth of endometrial tissue outside the uterus. This condition is called endometriosis. During normal ovulation, an egg is released from one ovary and travels down one of the fallopian tubes where it may meet a sperm cell. If the tube is twisted or blocked by tissue, the egg may never meet the sperm cells, resulting in infertility. The ultrasound exam will search for any signs that the fallopian tubes are affected by abnormalities of this kind.

Uterus and uterine lining - physical defects in the uterus can prevent an embryo from implanting there and growing into a baby, even when fertilization is successful. One such physical defect is endometriosis, mentioned above, which can cause the uterine lining to grow in the wrong place, and cause obstructions. Another is uterine fibroids. These are benign tumors that grow inside the uterus, but they can make the surface of the uterine lining too uneven for an embryo to implant. Another possibility is that, due to a hormone imbalance, the uterine lining may grow too thin or too thick, which can also prevent implantation. Signs of all these problems may be detected by a transvaginal ultrasound fertility test.

The Results

Although the person who carries out the ultrasound exam may not necessarily be a qualified fertility doctor or gynecologist, the patient will be given a follow up appointment with a fertility specialist, or gynecologist, after the test. This will involve looking at the images recorded, and reading the report of the person who performed the exam, to determine what the next step in fertility treatment should be.

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