Transvaginal ultrasound: 8 reasons to have one

A transvaginal ultrasound scan is a key fertility procedure if you want a baby. Most women have their first scan (abdominal, not vaginal) at the 12-week mark, once they’re pregnant. But not everyone gets pregnant. And there’s often a physical reason why. A transvaginal scan is a cheap, safe and effective way to check your cervix, uterus, fallopian tubes and ovaries. You want them in peak reproductive order.

Fertility patients have routine transvaginal ultrasounds during treatment cycles. For women planning a family naturally, get scanning too. Why struggle to conceive, only to have a transvaginal ultrasound diagnose a problem you could have spotted months earlier?

So what happens during a transvaginal ultrasound scan? A probe, lubricated with gel and covered by a condom, is inserted about three inches into your vagina. Not as scary as it sounds. Harmless sound waves (not x-rays) create computer-generated images of your pelvic organs. These photos are surprisingly clear – and they need to be to highlight problems. It’s all over in 15 minutes. The procedure is usually painless.

What exactly does a transvaginal ultrasound scan look for? Quite a lot, actually. These are the top 8 reasons for having one.

1. Find those fibroids.

Fibroids are benign growths in the uterus. 1 in 4 women have them, though they may not know it. Depending of their size and position, some fibroids make it harder to get pregnant and increase the chance of a miscarriage. This is more likely when the fibroids grow into the uterine cavity. A transvaginal ultrasound spots fibroids a mile off.

2. See those cysts.

Ovarian cysts are fluid-filled structures. Most are harmless and won’t stop you conceiving. Many come and go. But if you have endometriomas (cysts resulting from endometriosis) or cysts due to PCOS, your fertility could be affected. Transvaginal ultrasound examinations identify ovarian cysts with ease. And if they’re dodgy, there are things you can do.

3. Look at that lining.

TV scans love uterine linings. A transvaginal ultrasound scan performed mid-cycle measures your endometrium down to the last millimetre. If it’s too thin, at the point in your cycle where it should be optimally thick, this may be why you’re not getting pregnant. And if you’re transferring donor eggs, donor embryos or frozen embryos, a transvaginal scan of your lining during stimulation is essential. Uterine receptivity is everything.

4. Follow those follicles.

For women undergoing super-ovulation, transvaginal ultrasound tracking is crucial. TV scans get up close and personal, enabling the sonographer to accurately measure the quantity and size of your developing follicles. A typical patient needs 1 to 4 scans before her hCG trigger shot and egg retrieval.

5. Conception checker.

Fertility patients should always have an early (seven week) scan after a positive pregnancy test. This will check for an ectopic pregnancy, since the risk is higher following assisted reproduction. It can also spot other pregnancy problems, such as a blighted ovum. And of course a scan will detect fetal heart activity. Transvaginal ultrasound is the optimal way to see all these things. (To be fair, a transabdominal scan can see a lot too.) We think all pregnant women should have a seven-week scan, not just fertility patients. Early checks reduce stress and save lives.

6. Home in on that hydrosalpinx.

A hydrosalpinx is a collection of fluid in the fallopian tube. It can severely hamper a natural pregnancy (blocked tube) and also affect an IVF pregnancy (leaky fluid, wombs and embryos are a bad combination). Hydrosalpinges are often seen by transvaginal ultrasound – though a hysterosalpingogram can often see them better. Ask your doctor if you need one or both.

7. Pounce on your PID.

Pelvic inflammatory disease (PID) is not nice. And it can cause infertility. Your doctor may diagnose it based on touch and swabs. But a transvaginal ultrasound scan is a pretty good PID-identifier too. Early diagnosis is key.

8. Cross off cancer.

A TV scan can see female cancers of the lower organs better than an abdominal scan. Cancers of the uterus, vagina, ovaries, kidneys and bladder are not that common in your reproductive years. But check for them anyway.

So that’s why you need a transvaginal ultrasound scan. If you’re thinking of starting a family, a scan is a no-brainer. Shop around: we found prices ranging from £50 to £500 for exactly the same procedure. And remember the mantra: if you can, have the scan!