Transvaginal Ultrasonography Overview

A transvaginal, or endovaginal, ultrasound is a safe, straightforward way for doctors to examine the internal organs of the female pelvic region. An ultrasound test uses high-frequency sound waves to create images of your internal organs. Imaging tests can identify abnormalities and help doctors diagnose conditions. A transvaginal ultrasound also called an endovaginal ultrasound, is a type of pelvic ultrasound used by doctors to examine female reproductive organs. This includes the uterus, fallopian tubes, ovaries, cervix, and vagina.

“Transvaginal” means “through the vagina.” This is an internal examination.

Unlike a regular abdominal or pelvic ultrasound, where the ultrasound wand (transducer) rests on the outside of the pelvis, this procedure involves your doctor or a technician inserting an ultrasound probe about 2 or 3 inches into your vaginal canal.

Transvaginal Ultrasonography Procedures

This is a most useful tool for the diagnosis and management of female infertility. Within a matter of a few seconds it is possible to diagnose problems in the uterus such as a thin endometrium, intrauterine adhesions, endometrial polyp, submucous fibroid, uterine septum, arcuate or subseptate uterus. With the newly acquired 4-D machine (Samsung R7) we can reconstruct the entire womb (uterus) in a 3-D fashion to accurately diagnose problems with uterine structure and receptivity. Also, color Doppler would show the blood flow to the uterus and help in the timing of the embryo transfer and predict the chances of pregnancy. Also, TVS can diagnose problems with the fallopian tube if a hydrosalpinx is seen (indicative of a blocked tube) and diagnose ovarian conditions such as ovarian simple cyst, endometriosis (chocolate cyst) and other such pelvic pathologies. It is possible to predict the nature of the lesion as to whether it is benign or malignant in nature and whether any surgical correction is required for the same.

With this kind of detailed evaluation it is possible to avoid unnecessary hysteroscopies and laparoscopies before proceeding with IVF. The clinic tries to avoid unnecessary surgical procedures.

Furthermore, in most cases of tubal factor infertility such as blocked tubes it is mandatory to rule out the presence of a proximally patent hydrosalpinx (blocked tube which is filled with infected water which can still enter the uterus). This would imply drainage of potentially infected fluid draining into the uterine cavity thereby reducing IVF implantation rates from 40% to 5%. If we diagnose a hydrosalpinx on TVS ultrasonography we know that the patient needs an operative laparoscopy to first rectify this condition before embarking upon the IVF program.

TVS is also the main tool for interventional surgical work such as oocyte retrieval (egg recovery) for IVF and ICSI.

We also offer TVS ultrasonography for monitoring of early pregnancy, diagnosing twins, presence of a tubal pregnancy or complications such as ovarian enlargement, hyperstimulation, ascites and ovarian torsion for our pregnant patients.

What is a transvaginal ultrasound used for?

A healthcare professional uses ultrasound to create images of the inside of the body. High-frequency sound waves bounce off the internal organs and form these images.
There are two ways to perform an ultrasound — abdominally and transvaginally.
A transvaginal ultrasound is an internal scan of the female reproductive organs. It involves inserting a small ultrasound probe, called a transducer, into the vagina to produce incredibly detailed images of the organs in the pelvic region.

It may be necessary to use a transvaginal ultrasound to examine the:

  • vagina
  • cervix
  • uterus
  • fallopian tubes
  • ovaries
  • bladder

Transvaginal ultrasounds can check for:

  • the shape, position, and size of the ovaries and uterus
  • the thickness and length of the cervix
  • blood flow through the organs in the pelvis
  • the shape of the bladder and any changes
  • the thickness and presence of fluids near the bladder or in the:
    • fallopian tubes
    • myometrium, the muscle tissue of the uterus
    • endometrium

Doctors may request a transvaginal ultrasound for a variety of reasons. For example, it might be necessary to identify the cause of:

  • pelvic pain
  • unexplained vaginal bleeding
  • infertility
  • abnormal results of a pelvic or abdominal exam

These scans can also help diagnose:

  • benign growths, such as fibroids, cysts, and masses
  • pelvic inflammatory disease
  • endometriosis
  • postmenopausal bleeding

In addition, it can check for the presence of an intrauterine contraceptive device.

Doctors may request a transvaginal ultrasound during pregnancy, as it can help:

  • check the heartbeat of the fetus
  • confirm the date of delivery
  • assess the condition of the placenta
  • check for an ectopic pregnancy
  • monitor pregnancies with a higher risk of pregnancy loss