The scope of ultrasounds in infertility treatments

In the past, ultrasound for infertility was done by placing a transducer on the abdomen.  This required a full bladder for greater accuracy so that the sound waves could be transmitted into the abdomen and pelvis.  However, the standard ultrasound technique used for infertility is now the vaginal, or endovaginal, ultrasound.  The procedure is much more advanced. A long, thin probe is inserted into the vagina. This probe is used for imaging the pelvic organs.  The pictures generated from a vaginal ultrasound are sharper and clearer because having the probe inside of the vagina allows the probe to get much closer to the pelvic structures.

What can be viewed on ultrasound for infertility treatments?

Ovulation scans are important in evaluating follicle size. These ultrasounds allow the gynecologist to more precisely determine when the egg matures and when ovulation occurs.  This is often the fundamental procedure for determining infertility treatments around the time of ovulation.  Daily scans are needed to visualize the emergent follicle, which looks like a black bubble on the ultrasound screen.  Useful information detected and established by these scans is the thickness of the endometrium (the uterine lining).  The ripening follicle produces estrogen, which causes the endometrium to thicken.  The gynecologist can get an excellent approximation of how much estrogen is being produced in the body based on the thickness and clarity of the endometrium on the ultrasound scan.

Multiple follicles

Multiple follicles look like black bubbles

A triple band of the myometrium in the center of the uterus

A triple band of the myometrium in the center of the uterus

When the follicle reaches a certain size (depending on whether or not the patient has been taking fertility medication, this size will vary) a trigger injection can be given. A trigger will lead to ovulation about 36 hours after administration. The treating gynecologist will determine whether there is a need for infertility treatment after a tubal reversal surgery prior to a tubal ligation reversal. It is important that specialists in this very difficult and delicate procedure will determine the likelihood that the patient will even need such treatment BEFORE the tubal reversal surgery. The determination will involve identifying the egg quality to recommend either an IVF procedure or a tubal reversal. This evaluation is based on and mostly determined by the follicles’ growth and ability to ovulate.

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