Ultrasound Examination is an integral part of an Infertility Evaluation
An important aspect of fertility evaluation is looking at the womb – the uterus. An internal ultrasound is done as part of the basic testing to look closely at the shape and size of the uterus as well as to evaluate the uterine lining and any other abnormality (e.g. fibroid, polyp, or septum). As other specialties may not look at the uterus the same way that we do, even if you have had a previous ultrasound elsewhere, your physician will want to repeat the ultrasound. The ultrasound also gives us important information about the ovaries – how they look and where they are located. Usually, fallopian tubes are not seen on ultrasound, so a separate test (called an HSG) is usually required to look at them more closely.
Ultrasound is an imaging technique that uses sound waves to painlessly generate an image of a variety of different organs and structures. In an Infertility practice, it is an invaluable resource that allows your physician to evaluate primarily your uterus and ovaries for the presence of such abnormalities as uterine fibroids, polyps, ovarian cysts and other structural problems.
Most fertility-related ultrasounds are performed transvaginally. Though this is a more invasive procedure than a transabdominal ultrasound, the uterus and ovaries can be visualized much more effectively with the help of a transvaginal ultrasound, as the probe can be painlessly placed within a few inches of the structures being evaluated. The transvaginal ultrasound is performed using a thin ultrasound transducer (“probe” or “wand”) that is covered with a lubricated condom-like sheath. If you are allergic to latex, be sure to mention this before the exam so that a latex-free cover can be used.
During the exam, your physician will insert the tip of the transducer two or three inches into the vagina and evaluate the resulting images from several different orientations. The procedure is not painful – most women, in fact, say that it’s easier and less uncomfortable than having a Pap smear.
If your doctor decides a transabdominal ultrasound is also necessary, a different ultrasound probe will be placed on your lower abdomen to obtain images. You may be asked to drink a few glasses of water shortly before the test, since a full bladder will enable your doctor to see your organs more clearly.
The ultrasound machines used at Texas Fertility Center are very sophisticated and have many enhanced features. Every machine has Doppler capability, which enables the physicians or sonographer to evaluate blood flow to the different organs. We can also use Doppler to see and hear a fetal heartbeat very early in pregnancy – usually before seven weeks’ gestation.
Your physician will usually perform an ultrasound examination as part of your initial visit in order to evaluate your pelvic organs for a variety of factors. For example, your uterus will be examined for size, shape, position, and contour. The wall and cavity of the uterus will be evaluated for the presence of uterine fibroids, polyps, and developmental abnormalities.
Ultrasound also enables us to perform a thorough evaluation of your ovaries, looking specifically for cysts or solid masses. We can also examine your ovarian size and the presence and quantity of developing follicles (the sacs that contain the eggs) in order to get an idea of your ovarian reserve. Finally, by gently moving the ultrasound probe, we can assess the mobility of your pelvic organs if we suspect that you may have pelvic adhesions (scar tissue).
We most commonly use transvaginal sonograms to monitor the growth and development of follicles in patients who are undergoing stimulation with fertility medications. We can also monitor the development of the uterine lining in these cycles, as ultrasound usually gives a clear picture of the uterine cavity as well.
On occasion, we use ultrasound for other purposes, such as to provide visualization for the nonsurgical, in-office treatment of ovarian cysts or ovarian hyperstimulation syndrome. This has enabled hundreds of patients to avoid a surgical procedure – saving them valuable time they would have had to take off from work and lowering healthcare costs for both our patients and their insurance companies.
Types of Fertility Ultrasound Examination