INFERTILITY AND SONOGRAPHY
Ultrasound plays a large role in the assessment and management of women who are having difficulty conceiving. It is important for patients to understand ultrasound as they proceed with their care.
Ultrasound is essential for so many treatment plans. For example, it’s used for monitoring endometrial development, follicle development, and ovulation, particularly for women who are taking fertility drugs. For these monitoring exams, we will be present to check your progress, and the good news is that these ultrasound check-ups only last about five minutes
We perform transabdominal and transvaginal ultrasounds
The Transabdominal Ultrasound
For general gynecologic assessment, we often choose transabdominal ultrasound. It is routinely used to evaluate the condition of the uterus and ovaries, and it’s helpful in the detection of cysts.
For transabdominal ultrasound testing, all of the action will happen on your lower belly. To prepare, you may be asked to drink up to six glasses of water an hour before the test, since a full bladder will push the intestines out of the way of the other organs.
Once you’re face-up on the table, we will apply gel to your abdomen. This will facilitate the movement of a small, hand-held device called a transducer. The transducer sends reflected sound waves to a nearby computer, producing images on the monitor. You’ll remain still as the transducer is moved gently but firmly over the skin. You may feel tickling or temporary pressure if the technician presses down, but the procedure is painless. When you’re done, the gel will be wiped away, and you can empty your bladder , and get dressed. You can expect to resume your normal activities right away
The Transvaginal Ultrasound
More often, we require higher-resolution images, the kind that can be obtained with a transvaginal ultrasound. It may sound daunting, but it’s not so bad. The transvaginal ultrasound is performed with a small, very thin, s transducer that is covered and lubricated During the exam, we inserts the tip of the transducer two or three inches into the vagina, then captures images from different orientations. Although you may find yourself wishing you were on a beach somewhere instead of in stirrups, the procedure is not painful. Most women, in fact, find that it’s easier than a Pap smear, and when it’s over, it’s over.
Ultrasound for infertility
An infertility ultrasound is an important first test for any women experiencing difficulty conceiving. First, an infertility ultrasound will verify that the uterus and both ovaries are present. Ultrasound does not reliably detect the fallopian tubes. for this evaluation a hysterosalpinogram is performed. The size, shape and position of the uterus are recorded. Masses within the uterus called fibroids can measured and mapped. The ovaries can also be measured. The size of the ovaries as well as the number of follicles present are an important determinant of a woman’s ovarian reserve .
A common abnormal finding on an infertility ultrasound is ovarian cysts. Most often, ovarian cysts are simply evidence of a growing egg or evidence of recent ovulation. On occasion, however, a cyst may represent an abnormality such as endometriosis .
The most common treatments used for infertility employ the use of fertility medications. These medications stimulate the development of eggs in the ovaries. The eggs grow inside of the follicles. The follicles fill with fluid and enlarge while the egg is developing. The size and number of these developing follicles can be accurately determined with infertility ultrasound. In this way, the physician can determine the appropriate time to either trigger ovulation or perform an egg retrieval.
Infertility ultrasound is also used to monitor the growth and development of the uterine lining. while most of the uterus is composed of muscle, the innermost layer which surround the uterine cavity is made of glandular tissue. Under the influence of hormones produced from the ovaries, the uterine lining will grow and thicken. The thickness of the uterine lining can be measured and patterns of appearance can be seen.
Finally, although normal fallopian tubes are usually not seen on an infertility ultrasound, a type of abnormal fallopian can be seen. Occasionally, if the distal end of a fallopian tube become blocked, the tube will fill with fluid. This is called a hydrosalpinx. It is important to determine the presence of a hydrosalpinx since the presence of hydrosalpinges will indicate not only blocked fallopian tubes but also reduce the success rate of treatments such as IVF.
Ultrasound for monitoring pregnancy
After a pregnancy has been established in a patient with infertility or recurrent miscarriage, it is important to monitor the growth and development of the pregnancy. sometimes, a pregnancy may not be located within the uterus as it should be. This type of pregnancy complication is called an ectopic pregnancy . Other times, the pregnancy may be within the uterus but not viable. A non-viable pregnancy is called a miscarriage .
We also employ ultrasound to guide medical instruments during surgical procedures, such as egg retrieval for IVF. If early pregnancy is detected, ultrasound is commonly used to confirm the location of the pregnancy and assess the gestational sac. And when fertility treatments have succeeded, an ultrasound is frequently used to detect the heartbeat of a fetus, or two!
Conclusion
Ultrasound is a valuable tool to assist us in caring for the woman who has reproductive problems. Advances in ultrasound technology over the years has improved the image quality as well as the type of problems that can be identified.
Ultrasound tests for fertility don’t produce exciting, 3-D, look-at-our-baby sonograms, but they are useful and virtually risk- and pain-free. Most importantly, they provide information that can help and your partner achieve your dreams.