Ultrasound examination is an integral component of an infertility evaluation and also of subsequent infertility treatment.
NJ fertility doctor Jane Miller explains to her patients that reproductive endocrinologists use ultrasound to look at the pelvic anatomy for important clues as to why they are having trouble conceiving. In our specialty we use a vaginal ultrasound probe which can give us more information than can an abdominal transducer. While both probes use safe and painless sound waves to generate pictures of the pelvic organs the vaginal probe allows us to get “right up to” the uterus and ovaries so that we can see their anatomy in the greatest detail possible.
For the vaginal ultrasound exam the probe is covered with a lubricated sheath which makes its insertion into the vagina virtually pain-free. It is inserted 2 to 3 inches towards the cervix and is gently moved to the right and left. We are then able to see views of the entire pelvis and we show you the ultrasound machine screen so that you can see along with us.
NJ fertility doctor Jane Miller uses the ultrasound or sonogram (as it is also called) to look at the position of the uterus as well as its size, shape and angle of flexion in relation to the cervix. A uterus can be anteverted (flexed forward), retroverted (flexed backwards) or axial (straight back) in position. Dr. Miller looks for abnormalities such as polyps, fibroids, or developmental abnormalities.
The ultrasonographic picture of the endometrium (uterine lining) should change in thickness and pattern during different days of a woman’s cycle. This picture can give us important information that will help us understand why a patient may not be getting pregnant or why she is having early miscarriages.
Ultrasound enables us to evaluate the ovaries: their size, their position in the pelvis, and the number of follicles (the sacs that contain eggs) in each. This is important to help determine which treatment and medication regimen may be appropriate for any one patient. In patients who are undergoing ovarian stimulation with these medications ultrasound is used throughout the cycle to evaluate the growth of the developing ovarian follicles.
During the ovarian ultrasound exam Dr. Jane Miller can find cysts or solid abnormalities that may be contributing to a patient’s infertility. These abnormalities may or may not cause pelvic discomfort. Dr. Miller will review her findings with her patients and discuss with them whether they need to be addressed prior to beginning treatments to become pregnant.
Finally, fertility doctor Jane Miller uses vaginal ultrasound to monitor early pregnancy. Gestational sac size and location, yolk sac size and fetal heartbeat are assessed in the first 7 weeks of pregnancy. By the 8th week and going forward the fetal measurements and growth are assessed. After the first trimester most obstetric ultrasounds are performed abdominally as a more complete evaluation of fetal development can be done this way. The transabdominal ultrasound exam should be done on a patient with a full bladder so drinking a few glasses of water before the test helps us see the developing baby more clearly.