Transvaginal Ultrasonography (TVS) in Female Infertility Evaluation

Transvaginal Sonography for Female Infertility Diagnosis

A transvaginal ultrasound is an internal exam which uses high-frequency sound waves to create images of your internal organs. It is a non-invasive procedure used by doctors to examine female reproductive organs. It helps examine the cervix, uterus, ovaries, the pelvic areas, fallopian tubes, the vagina, and the bladder. It can help identify abnormalities and diagnose conditions in case of infertility.

• Problems with the structure of the ovaries or the uterus
• Cancer of the ovaries, uterus, or bladder
• Locating an intrauterine device (IUD)
• Growths which are non-cancerous such as fibroids, cysts, or benign tumours
• Find the cause of abnormal bleeding or pelvic pain
• Check for pelvic inflammatory diseases such as infection of the uterus, fallopian tubes, or ovaries
• Diagnose an ectopic pregnancy (a fertilised egg growing outside the uterus)
• Check the baby’s growth in case of a pregnancy
• Follicular study during IUI and IVF
• Egg retrieval

Preparation of Transvaginal Ultrasound

If you’re having a transvaginal ultrasound or a pelvic scan, make sure to check with the doctor about clear instructions about food and water intake.

A few things you can keep in mind are as follows:

• Wear loose and comfortable clothes. At times, you may be asked to change into a gown before the examination
• Your bladder may need to be partially or fully empty depending on the reason for the scan. Check with your doctor about this
• If your bladder needs to be full, you may need to drink about half a litre of water an hour before the procedure. Make sure you ask your doctor about exactly how much water you need to drink
• Generally fasting is not required for this procedure but it is best to ask the doctor if you need to fast a few hours before the scan
• You may also be asked to remove jewellery, watches, or other items as they may interfere with the scan

Transvaginal Ultrasound Procedure

1. You will be asked to lie down on an examination table with your knees bent
2. The doctor will cover the ultrasound wand with a gel and a condom
3. The transducer is then inserted in your vagina. You may feel some pressure when this happens and may feel a bit uncomfortable, but it won’t hurt
4. Once the transducer is inside you, it transmits sound waves and records the reflections of those waves off body structures. The ultrasound machine then creates image of that body part
5. The doctor or the technician may then turn around the transducer to get clearer pictures of some organs
6. In some cases, the doctor may perform a saline infusion sonography (SIS) which is a special transvaginal ultrasound which involves inserting sterile salt water into the uterus before the scan. This helps identify any abnormalities in the uterus
7. A transvaginal ultrasound is also helpful for egg retrieval. In case of an egg retrieval, a thin needle is attached to the transducer and using image guidance, the egg is retrieved

Result of Ultrasound Transvaginal Scan (TVS)

Results of a transvaginal ultrasound or a pelvic scan are immediate. The images are saved by the radiologist soon after the scan is complete and may help the doctor determine whether further testing or procedures are needed.

A transvaginal ultrasound may help in identifying the following conditions related to an infertility:

• Cancer of the reproductive organs
• Fibroids and cysts
• Pelvic infection
• A pregnancy
• Miscarriage
• Size, shape and position of the uterus and the ovaries
• Thickness, echogenicity (darkness or lightness of the image related to the density of the tissue), and presence of fluids or masses in the endometrium, myometrium (uterine muscle tissue), fallopian tubes, or in or near the bladder
• Changes in bladder shape
• Blood flow through the pelvic organs
• Length and thickness of the cervix
• Abnormalities in the anatomic structure of the uterus, including endometrial conditions
• Monitoring of ovarian follicle size for infertility evaluation
• Size of the follicle and blood flow of the follicle
• Aspiration of follicular fluid and eggs from ovaries for in vitro fertilisation

Transvaginal Ultrasound Cost

The price of a transvaginal ultrasound examination depends on the condition that your doctor is trying to diagnose and what is being prescribed. However, a basic pelvic USG would cost Rs 800 to Rs 1500/-

Conclusion

A transvaginal ultrasound or a pelvic ultrasound helps in identifying many abnormalities in the pelvic area, ovarian follicles, uterus, and other reproductive organs. While it is a simple scan, it plays an important role in IVF treatment and otherwise.