A Fertility Ultrasound: What Are We Looking For?
When we are trying to determine what may be causing fertility challenges, one of the key tests that we recommend is a fertility ultrasound. This ultrasound is very similar to a pelvic ultrasound but is done by an ultrasonographer with experience and training in the evaluation of infertility.
The type of ultrasound performed is a transvaginal ultrasound, which is a small vaginal probe inserted into the vaginal canal so that the uterus and ovaries can be carefully examined. We are looking at the overall structure and size of these two organs, but also looking for obvious (and not so obvious) abnormalities. Depending on where you are in your cycle, we can determine how your uterus and ovaries are responding to the hormonal communication from the brain. Sometimes we can determine if you have ovulated already or if your body is still preparing for ovulation. We will collect data on the thickness of your uterine lining and determine if you have any abnormalities (such as fibroids or polyps) that could be causing implantation difficulties.
Occasionally, we will see an abnormality on ultrasound that needs additional follow up. Sometimes this means we need to schedule an additional ultrasound at a different time in your cycle. Occasionally, we will see an abnormality that may benefit from surgical intervention. In this case we will help determine who/where is the best place to get that care.
A Saline Infused Sonogram (aka SIS or Sonohystogram) is a specific ultrasound procedure to evaluate the uterine cavity. This procedure involves placing a catheter (small tube) through the cervix, and while sterile saline is passed through the catheter to distend the cavity, a transvaginal ultrasound is used to take images of the uterine cavity. This can assist in making a diagnosis of uterine polyp or fibroid, which is an important determination in the fertility evaluation.
If you are having an ultrasound done during the first half of your cycle, an Antral Follicle Count (AFC) can be completed. The AFC test involves a visual inspection of the ovaries with a transvaginal ultrasound and a counting of resting follicles within the ovaries. Eggs are microscopic, so we are unable to visualize eggs on an ultrasound, but we can see the fluid collections that surround eggs. These structures are called “follicles.” During every cycle, women have a certain resting group of antral follicles that are available for recruitment to ovulation. Through the beautiful hormonal communication, usually only one egg from the group matures and develops in preparation for ovulation. The other follicles that were not selected die off. Therefore, eggs are constantly being recruited and lost, even when we’re not trying to conceive or on birth control. While experts are still trying to determine a “normal” AFC, the understanding is that the higher number of follicles, the better the ovarian reserve.
These are just a few of the procedures we offer at Nurture Women’s Health and Fertility. Whether you are just starting your fertility journey, or you have been at it for some time, we are here to support you through this delicate time.
About The Author
Dana Ramsey is a Certified Nurse Midwife and has spent the past 15 years helping women navigate their gynecology, pregnancy, postpartum, and menopausal challenges. Dana is dedicated to helping her patients overcome conditions impacting their ability to conceive and maintain a successful pregnancy.
