Introduction
If you are trying to conceive and facing difficulties, you may wonder what is causing your fertility problems and how to find out. One of the most common and useful tests that can help diagnose your fertility issues is a pelvic ultrasound. A pelvic ultrasound is a non-invasive and painless procedure that uses sound waves to create images of your reproductive organs, such as your uterus, ovaries, and fallopian tubes. It can help detect and evaluate various conditions that can affect your fertility, such as ovarian cysts, fibroids, endometriosis, polycystic ovary syndrome (PCOS), and tubal blockage. It can also help monitor your ovulation and the development of your follicles and eggs.
In this blog post, we will explain what a pelvic ultrasound is, how it works, what it can show, and how it can help you improve your chances of getting pregnant. We will also answer some of the most frequently asked questions about pelvic ultrasound and fertility, such as when to do it, how to prepare for it, and what to expect from it.
What is a Pelvic Ultrasound and How Does it Work?
A pelvic ultrasound is a type of imaging test that uses high-frequency sound waves to create pictures of your pelvic organs. The sound waves are emitted by a device called a transducer, which is either placed on your abdomen (transabdominal ultrasound) or inserted into your vagina (transvaginal ultrasound). The sound waves bounce off your organs and tissues and are captured by the same device. The device then sends the signals to a computer, which converts them into images that can be seen on a monitor.
A pelvic ultrasound can be done in a doctor’s office, a clinic, or a hospital, and usually takes about 15 to 30 minutes. It does not involve any radiation or contrast dye, and does not have any known risks or side effects. However, some women may experience some discomfort or pressure during the transvaginal ultrasound, especially if they have an infection, inflammation, or a full bladder. To minimize the discomfort, you can ask your doctor to use a smaller transducer, apply more lubricant, or adjust the angle or depth of the insertion.
What Can a Pelvic Ultrasound Show and How Can it Help Diagnose Fertility Problems?
A pelvic ultrasound can show the size, shape, position, and structure of your pelvic organs, such as your uterus, ovaries, and fallopian tubes. It can also show the presence and characteristics of any abnormal growths, masses, or fluid collections in your pelvic cavity, such as cysts, fibroids, polyps, or adhesions. By examining these images, your doctor can diagnose and evaluate various conditions that can affect your fertility, such as:
- Ovarian cysts: Ovarian cysts are fluid-filled sacs that develop on or in the ovaries. They can be functional or pathological, depending on their cause and nature. Functional cysts are normal and harmless, and usually disappear on their own. They are formed as a result of the normal ovulation process, such as follicular cysts, which are formed when the follicle does not release the egg, or corpus luteum cysts, which are formed when the follicle does not dissolve after releasing the egg. Pathological cysts are abnormal and potentially harmful, and may require treatment. They are formed as a result of an underlying disease or disorder, such as endometriosis, PCOS, or ovarian cancer. Ovarian cysts can affect your fertility by interfering with the ovulation, the egg quality, or the implantation of the embryo. A pelvic ultrasound can help detect and measure the size, shape, location, and content of the ovarian cysts, and determine whether they are functional or pathological, and whether they need further evaluation or treatment.
- Fibroids: Fibroids are benign tumors that grow in or on the wall of the uterus. They can vary in size, number, and location, and can be submucosal, intramural, or subserosal, depending on whether they are inside, within, or outside the uterine lining. Fibroids can affect your fertility by distorting the shape or size of the uterus, blocking the fallopian tubes, or impairing the blood supply or the implantation of the embryo. A pelvic ultrasound can help detect and measure the size, shape, location, and number of the fibroids, and determine whether they need further evaluation or treatment.
- Endometriosis: Endometriosis is a condition where the endometrium, which is the tissue that lines the inside of the uterus, grows outside the uterus, such as on the ovaries, fallopian tubes, or other pelvic organs. Endometriosis can cause inflammation, scarring, and adhesions, which can affect your fertility by interfering with the ovulation, the egg quality, the tubal function, or the implantation of the embryo. A pelvic ultrasound can help detect and evaluate the extent and severity of the endometriosis, and identify any endometriomas, which are cysts filled with endometrial tissue, or any adhesions, which are bands of scar tissue that connect the pelvic organs. A pelvic ultrasound can also help monitor the response to the treatment of endometriosis, such as medication or surgery.
- Polycystic ovary syndrome (PCOS): PCOS is a hormonal disorder that affects the ovaries and the ovulation. It is characterized by an imbalance of the sex hormones, such as estrogen, progesterone, and androgens, which can cause irregular or absent periods, multiple small cysts on the ovaries, excess hair growth, acne, weight gain, insulin resistance, and infertility. PCOS can affect your fertility by preventing the maturation and release of the eggs, or by affecting the quality of the eggs or the implantation of the embryo. A pelvic ultrasound can help diagnose PCOS by showing the presence and number of the ovarian cysts, and measuring the ovarian volume and the antral follicle count, which are indicators of the ovarian reserve and function. A pelvic ultrasound can also help monitor the response to the treatment of PCOS, such as medication, lifestyle changes, or ovulation induction.
- Tubal blockage: Tubal blockage is a condition where one or both of the fallopian tubes are obstructed or damaged, preventing the passage of the eggs or the sperm. Tubal blockage can be caused by various factors, such as infections, inflammations, surgeries, ectopic pregnancies, or endometriosis. Tubal blockage can affect your fertility by preventing the fertilization or the implantation of the embryo. A pelvic ultrasound can help detect and evaluate the presence and extent of the tubal blockage, and identify any hydrosalpinx, which is a fluid-filled dilation of the fallopian tube, or any salpingitis, which is an inflammation of the fallopian tube. A pelvic ultrasound can also help monitor the response to the treatment of tubal blockage, such as medication, surgery, or in vitro fertilization (IVF).
In addition to diagnosing and evaluating various conditions that can affect your fertility, a pelvic ultrasound can also help monitor your ovulation and the development of your follicles and eggs. This can help you optimize your timing of intercourse or insemination, or plan your fertility treatment, such as ovulation induction, intrauterine insemination (IUI), or IVF. A pelvic ultrasound can also help confirm your pregnancy and check the viability and health of the embryo.
Frequently Asked Questions About Pelvic Ultrasound and Fertility
Here are some of the most frequently asked questions about pelvic ultrasound and fertility, and their answers:
- When should I do a pelvic ultrasound?
The timing of your pelvic ultrasound depends on the purpose and the type of the ultrasound. Generally, a pelvic ultrasound can be done at any time of your menstrual cycle, but some conditions or situations may require a specific timing. For example:
If you want to check your ovarian reserve and function, you should do a pelvic ultrasound on day 2, 3, or 4 of your cycle, when your ovaries are at their baseline state, and measure your antral follicle count and ovarian volume.If you want to monitor your ovulation and the development of your follicles and eggs, you should do a pelvic ultrasound on day 10, 11, or 12 of your cycle, when your follicles are growing and approaching their peak size, and measure your follicular diameter and endometrial thickness.If you want to confirm your pregnancy and check the viability and health of the embryo, you should do a pelvic ultrasound at least six weeks after your last menstrual period, when the embryo and its heartbeat can be seen-
How should I prepare for a pelvic ultrasound?
The preparation for a pelvic ultrasound depends on the type of the ultrasound. Generally, a pelvic ultrasound does not require any special preparation, but some tips may help you have a better experience. For example:
If you are having a transabdominal ultrasound, you should drink plenty of water before the ultrasound, and avoid emptying your bladder until the ultrasound is done. This can help create a better acoustic window and improve the quality of the images. However, if you feel too uncomfortable or have a history of urinary tract infections, you can ask your doctor to adjust the amount of water or allow you to empty your bladder partially.If you are having a transvaginal ultrasound, you should empty your bladder before the ultrasound, and avoid- If you are having a transvaginal ultrasound, you should empty your bladder before the ultrasound, and avoid using any vaginal products, such as creams, gels, or douches, for at least 24 hours before the ultrasound. This can help prevent any infection or irritation, and improve the accuracy of the images. You should also wear comfortable and loose clothing, and bring a sanitary pad or a panty liner, as you may have some spotting or discharge after the ultrasound.
- If you are having a pelvic ultrasound for fertility purposes, you should inform your doctor about your menstrual cycle, your ovulation date, your fertility treatment, and any medications or supplements that you are taking. This can help your doctor interpret the results and plan the next steps accordingly. You should also ask your doctor any questions or concerns that you may have about the ultrasound, such as the purpose, the procedure, the risks, the benefits, and the outcomes.
What should I expect from a pelvic ultrasound?
The experience of a pelvic ultrasound may vary depending on the type of the ultrasound, the reason for the ultrasound, and the individual. Generally, a pelvic ultrasound is a simple and quick procedure that does not cause any pain or discomfort. However, some women may feel some pressure or cramping during the transvaginal ultrasound, especially if they have an infection, inflammation, or a full bladder. To minimize the discomfort, you can ask your doctor to use a smaller transducer, apply more lubricant, or adjust the angle or depth of the insertion.
During the pelvic ultrasound, you will lie down on an exam table, with your lower abdomen or pelvis exposed. If you are having a transabdominal ultrasound, your doctor will apply a gel on your abdomen, and move the transducer over your skin, while watching the images on the monitor. If you are having a transvaginal ultrasound, your doctor will insert the transducer into your vagina, and move it around, while watching the images on the monitor. You may be asked to change your position or hold your breath at some point, to get a better view of your organs. You may also hear some sounds or see some colors on the monitor, which are normal and indicate the blood flow or the movement of the organs.
After the pelvic ultrasound, your doctor will remove the transducer and wipe off the gel from your skin. If you had a transvaginal ultrasound, you may have some spotting or discharge, which is normal and should go away in a few hours. You can resume your normal activities and diet after the ultrasound, unless your doctor tells you otherwise. Your doctor will review the images and the report, and discuss the results and the next steps with you. You may also receive a copy of the images or the report, or have them sent to your email or your online account.
Conclusion
A pelvic ultrasound is a valuable and versatile test that can help diagnose and evaluate various conditions that can affect your fertility, such as ovarian cysts, fibroids, endometriosis, PCOS, and tubal blockage. It can also help monitor your ovulation and the development of your follicles and eggs, and confirm your pregnancy and check the viability and health of the embryo. A pelvic ultrasound is a safe, painless, and non-invasive procedure that uses sound waves to create images of your pelvic organs. It can be done at any time of your menstrual cycle, but some conditions or situations may require a specific timing. It does not require any special preparation, but some tips may help you have a better experience. It usually takes about 15 to 30 minutes, and does not have any known risks or side effects. However, some women may experience some discomfort or pressure during the transvaginal ultrasound, which can be minimized by asking your doctor to use a smaller transducer, apply more lubricant, or adjust the angle or depth of the insertion.
If you are trying to conceive and facing difficulties, you may benefit from having a pelvic ultrasound, as it can help you identify and address the underlying causes of your fertility problems, and optimize your chances of getting pregnant. However, before having a pelvic ultrasound, you should consult your fertility expert / coach or doctor and get a proper diagnosis of your fertility problem. Your doctor can help you determine the best course of action for your specific case, and monitor your progress and outcomes. Your doctor can also help you avoid any potential risks or complications that may arise from having a pelvic ultrasound, such as allergic reactions, infections, or false positives or negatives. Your doctor can also help you decide whether to combine a pelvic ultrasound with other tests or treatments, such as blood tests, hormone tests, hysterosalpingogram, laparoscopy, hysteroscopy, medication, surgery, or ART, to optimize your chances of success.
Remember, in our fertility coaching session we always explain to our patients that fertility is not a one-size-fits-all issue, and everyone’s journey is different. What works for one person may not work for another, and what works today may not work tomorrow. Therefore, it is important to be patient, flexible, and open-minded, and to try different options until you find the one that suits you best. It is also important to be positive, hopeful, and supportive, and to seek help and guidance from your partner, family, friends, or professionals, whenever you need it. Fertility is not a destination, but a journey, and you are not alone in it. You can do it, and you will do it. We wish you all the best!
