fertility ultrasound explained

Overview

A fertility ultrasound is a safe, painless imaging test that uses sound waves to create pictures of your reproductive organs. It helps your healthcare team understand how your uterus, ovaries, and surrounding structures look and work, which can be useful when you are having difficulty getting pregnant.

It is a standard test and is very commonly used in fertility clinics around the world.

It is used for people who were assigned female at birth and are trying to conceive, including those who have been trying for a while or who have known gynecological conditions.

Symptoms

Common symptoms

• This test is not for symptoms, but it may be recommended if you and your partner have been trying to get pregnant for 12 months (or 6 months if you are over 35).
• You may also be offered it if you have irregular periods, very painful periods, or a history of pelvic infections.
• It can be used to monitor your cycle and check how your ovaries respond to fertility treatment.

Symptoms in children

• Fertility ultrasound is not used in children. It is only relevant for people of reproductive age.

Symptoms in older adults

• You may still have this test during perimenopause or early menopause if fertility is being explored, but the focus is usually on egg supply and uterine health.

Causes

Main causes

• Fertility ultrasound is not caused by a disease. Instead, it is used to look at possible causes of infertility, such as fibroids, ovarian cysts, polyps, or structural issues in the uterus.
• The scan can also reveal how many small follicles (egg sacs) are visible in your ovaries, which helps estimate your egg supply.
• It helps check the thickness and pattern of the uterine lining, which is important for embryo implantation.

Risk factors

• Conditions that may lead to a fertility ultrasound include polycystic ovary syndrome, endometriosis, or previous pelvic surgery.
• Your age, menstrual cycle regularity, and partner's fertility history can also affect whether you are offered this test.
• If you have had multiple miscarriages, your doctor may use ultrasound to look at the shape of your uterus.

When to see a doctor

See a doctor urgently if:

• If you are trying to conceive and experience severe pelvic pain or unusual bleeding, seek medical attention promptly.
• If you are scheduled for a fertility ultrasound and develop a fever or severe pain, call your clinic before arriving.

Book a routine appointment if:

• See your doctor if you have been trying to conceive for more than a year (or more than six months if you are over 35), if you have irregular periods, or if you have been advised to have a fertility investigation.
• Make an appointment if you have symptoms like pelvic pain that worry you.

Diagnosis

A fertility ultrasound is itself a diagnostic test. It does not diagnose infertility on its own, but it provides useful information that your fertility team will combine with your medical history, blood tests, and your partner's tests to build a full picture.

Tests that may be done

• Transabdominal ultrasound: a probe is moved gently over your abdomen, often with a full bladder.
• Transvaginal ultrasound: a small, rounded probe is placed inside the vagina to get closer, clearer images of the uterus and ovaries.
• Saline infusion sonogram (sometimes called a hysterosonogram): a small amount of sterile fluid is put into the uterus to make the cavity easier to see.

What to expect at your appointment

You will lie on a couch while a sonographer applies gel to your abdomen (or uses a slim vaginal probe for an internal scan). The scan usually takes 20 to 30 minutes. It is generally not painful, though the vaginal probe can feel a little uncomfortable. You can return to normal activities immediately afterwards.

Treatment

A fertility ultrasound does not require any treatment — it is a diagnostic step. If the scan shows something that could affect fertility, your doctor will talk you through the next steps. Many findings, such as tiny fibroids or simple ovarian cysts, are nothing to worry about.

Self-care at home

• Follow your appointment instructions about whether to have a full bladder.
• Wear loose, comfortable clothing so you can undress easily if needed.
• Ask a partner or friend to come with you if you feel nervous.

Medical treatments

If a condition is found, your provider may discuss options such as medication to balance hormones or support ovulation, or minor procedures to remove polyps or fibroids. Always talk to your GP or fertility specialist before trying any treatment — do not take over-the-counter or unregulated products meant to help fertility.

When is surgery considered?

Surgery is only considered when ultrasound and other tests reveal a correctable structural problem, such as a blocked fallopian tube, large fibroids, or severe endometriosis. The exact operation, if any, will be explained by your specialist.

Living with this condition

After the scan, you can go back to your usual routine. If you are having fertility investigations, it may help to keep a clear calendar of your cycle and appointments, and to write down any questions for your next visit.

Lifestyle tips

• Try to stay relaxed before the appointment — deep breathing can help.
• Eat a balanced diet and stay hydrated, which supports your overall health.
• Avoid alcohol, smoking, and recreational drugs while trying to conceive.

Diet and exercise

No special diet is needed for the ultrasound itself, but keeping a healthy weight through a balanced diet and regular exercise supports general fertility. Ask your clinic for advice if you are unsure.

Mental health and emotional wellbeing

Fertility tests can be stressful. It is completely normal to feel anxious, sad, or frustrated during the process. Give yourself space to feel these emotions, and let your healthcare team know if you need extra support.

Prevention

You cannot prevent the need for a fertility ultrasound — it is a routine diagnostic tool. Many causes of infertility are not preventable, but maintaining a healthy lifestyle and getting regular gynecological check-ups may help your overall reproductive health.

Vaccines

No vaccine is related to this test. Your fertility team may check that you are up to date with routine vaccines before starting fertility treatment, because some infections can affect pregnancy.

Screening programmes

There is no general screening recommendation for fertility ultrasound in the general population, but if you have symptoms or fertility concerns, your doctor may recommend it as part of a focused assessment.

Complications

If left untreated

• If a treatable cause of infertility is found and ignored, it may continue to affect your chances of getting pregnant.
• In rare cases, conditions such as large fibroids or endometriosis can cause pain or heavy periods if not monitored.

Long-term outlook

The outlook is generally positive. Many people who have a fertility ultrasound receive reassuring results, and those who do need treatment often go on to conceive with the right support. This scan is a helpful step, not a prognosis.

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