Modern ultrasound scanning enables us to monitor a woman's ovulation cycles and fertility status. This can be particularly useful for couples who have had other causes of infertility ruled out, such as tubal problems or low sperm count. Ultrasound can also identify many pelvic and gynaecological disorders which can often be treated, removing the need for assisted conception.
Scanning techniques are improving all the time. In the early days, scans were performed abdominally (with gel on the tummy), scanning through all the layers of muscle and fat. The developement of vaginal scanning was a big step forward in improving the images. In another step forward, 3D scans are now often used ante-natally to get remarkable pictures of the unborn baby. And saline infusion sonohysterography, or "fluid ultrasound" offers an even further improvement on a standard trans-vaginal scan, providing a more detailed image of the endometrium.
High resolution trans-vaginal scanning (TVS) is a safe way to gain a tremendous amount of information. It can recognise the characteristic changes that take place during a natural cycle within the womb and ovaries. Colour Doppler Imaging (CDI) is able to demonstrate blood flow through very fine capillary vessels and highlight subtle vascular changes within the ovary associated with ovulation. 3-D ultrasound gives even more anatomical detail, providing a greatly improved assessment of the womb.
We often use ultrasound to monitor a woman's cycle, generally on a weekly basis, throughout the menstrual cycle. It can reassure women about ovulation and their womb lining, and give them more information about when they are ovulating. Cycles can be monitored while a woman is taking Clomid or having injections. If women are going through IUI, we often use ultrasound monitoring to reassure them that their cycles are working normally, and this gives them the confidence to carry on.
Carrying out between three and five scans during a woman's cycle can provide a wealth of information. For example, it can detect fibroids, endometrial polyps, endometriosis and polycystic ovaries, as well as anatomical malformations that might affect fertility or increase the risk of early miscarriage. Scans can also gauge the number and distribution of follicles, giving an idea of a woman's "ovarian reserve." They help us to predict accurately the timing of ovulation and the fertile phase of the cycle. They also provide an effective screening of the womb and ovaries.
For men, testicular/prostate scans can be helpful when semen analysis reveals issues that need further investigation.