When it comes to carrying a child, the uterus (womb) of a woman plays a vital role in the success of a pregnancy. The uterus is where the embryo (baby) implants and grows. Having a healthy environment to grow and nurture the baby is essential. No matter what type of fertility treatment you undergo, including IVF treatments and donor eggs, having a healthy uterus is important. Issues such as polyps, fibroids (myomas), and adhesions can interfere with the ability of the embryo to implant and grow. Below are some of the tests that can help evaluate the uterus.

Pelvic or Transvaginal Ultrasound

When most people think of ultrasound, they think of having a probe placed on their abdomen to take a look at the baby inside of the uterus. An examination of the abdomen is called “transabdominal ultrasound.” The good news is that most of our patients will have a transabdominal ultrasound in the near future to see their baby. To achieve this goal, though, we may first have to use transvaginal ultrasound to explore the underlying causes of infertility.

Pelvic, or transvaginal, ultrasound, is a procedure in which a specialized probe enters the vagina and allows a healthcare professional to examine the pelvic organs. A pelvic ultrasound is often referred to as an “internal” ultrasound because the probe enters the vagina.

Why Do I Need an Ultrasound?

The reason we do an internal ultrasound is that the closer the ultrasound probe is to the organs we are looking at, the better the images. So if the probe is somewhat far away from the uterus, as it is in the case of transabdominal ultrasound, the images are poor. However, if the probe is right next to the uterus, as it is with transvaginal ultrasound, then the images are much clearer. The better the images are, the more accurate a diagnosis we can make.

Transvaginal ultrasound gives us a lot of information about the uterus, endometrium, fallopian tubes, and pelvis. Ultrasound can help us visualize fibroids (myomas), polyps, and sometimes hint at adhesions inside the uterus. Using the ultrasound, we can determine the size and location of any of the above issues. This helps us identify if there is uterine factor infertility. Transvaginal ultrasound can also help determine the thickness of the lining of the uterus (the endometrium), which can play a role in infertility.

If the transvaginal ultrasound is abnormal, further testing may be helpful. These fertility tests may include a saline contrast ultrasound, hysteroscopy, and laparoscopy.

Saline Contrast Ultrasound

A saline contrast ultrasound (also known as a saline-infused sonogram [SIS] and sonohystogram [SHG]) is a specialized ultrasound that helps us visualize the internal cavity of the uterus.

When a standard transvaginal ultrasound is done, the uterine cavity (the womb) is collapsed.  For a saline contrast ultrasound, we place a little catheter in the uterine cavity. Then, saline is infused into the uterine cavity through the catheter. This causes the uterine cavity to open up.

Once the uterine cavity is open, we can see the internal details much more clearly. We can then determine if there is anything (such as a polyp or fibroid) that is affecting the cavity itself. Since anything that affects the uterine cavity can play a role with infertility, this test can be beneficial.

We perform the test in our clinic, and it usually only involves minimal discomfort.

Hysteroscopy

Hysteroscopy is a specialized test to evaluate the uterine cavity. Like the saline contrast ultrasound, we perform this test in our office, without an incision, and it usually only involves minimal discomfort. A hysteroscopy is the “gold standard” test for evaluating the uterine cavity.

The hysteroscopy takes a tiny camera and threads it through the cervix and into the uterus. The cervix has a natural opening, so no incision is necessary, and patients can go home after the procedure. Once in the uterus, saline opens (distends) the cavity, and we can see if there is anything (such as a polyp, fibroid, or adhesions) that is affecting the cavity itself. Anything that affects the cavity can play a role in infertility.

During the procedure, we can also determine if surgery is necessary to correct any problems found. If corrective surgery is required, it can usually be done on an outpatient basis with operative hysteroscopy. To learn more about your fertility treatment options, contact or call Advanced Reproductive Center at 312.485.4847 today!