Hysterosonogram/Ultrasound for Infertility

Ultrasound technology provides a nonsurgical way of viewing a woman’s pelvic organs during various infertility tests and procedures. It uses high-frequency sound waves that travel at different speeds through body organs and tissues. The waves are then reflected back to a detector where they are converted into pictures. The probe (transducer) that is used to assess and help treat infertility-related conditions is placed within the vagina (transvaginal).

A hysterosonogram is done to evaluate the inside of the uterus (endometrial cavity) by filling the uterus with fluid during a transvaginal ultrasound. This procedure is also known as a sonohysterogram.

Ultrasound used for monitoring of ovarian follicle development can provide information about the number and size of developing follicles, the reaction of the uterine lining (endometrium) to follicle growth, and when to schedule artificial or intrauterine insemination just before you ovulate. Transvaginal ultrasound is better than transabdominal ultrasound for monitoring follicle growth, counting the number of follicles, and evaluating the thickness and pattern of growth of the uterine lining.

Ultrasound is a rapid, vaginally invasive procedure, is usually not painful, and requires no special dietary preparations. It is performed on an outpatient basis. Results are interpreted by a radiologist or a gynecologist. Testing requires that you empty your bladder and takes about 20 minutes.

Why It Is Done

Transvaginal ultrasound may be done to:

View the external structures of the uterus, fallopian tubes, and ovaries.
Monitor the development of follicles in the ovary leading to ovulation. This helps to know when to schedule artificial or intrauterine insemination just before you ovulate.
View the uterus and uterine lining.
Guide the needle used to remove eggs to be used in assisted reproductive techniques.
Count the number of egg follicles in the ovaries, which, along with your age and blood tests, may be used to give an estimate of treatment success.

For a comparison between ultrasound and laparoscopy, see ultrasound and assisted reproductive techniques.

Results

Findings of ultrasound may include the following.

Normal

The uterus, fallopian tubes, and ovaries are of normal size and shape with no visible growths or scar tissue or injury site (abnormal attachments to the wall of the abdomen). Follicle number and development appear normal.

Abnormal

Problems may include:

Abnormally thick or deformed uterine lining.
Structural defects or enlarged uterus.
Growths within the organs, such as uterine fibroids or ovarian cysts.
Abnormalities of the fallopian tubes, such as hydrosalpinx.
Few visible egg follicles in the ovaries.

What to Think About

Small tumors and scars as well as some internal structures, such as a dividing tissue growth (septum) within the uterus, may not be visible with ultrasound.