Understanding Ultrasound Scans: Diagnosis & Monitoring for Fertility

Fertility Ultrasound Scan

[Published Mar 2022]

Ultrasound!? There are few things when TTC which can be more exciting, nor more terrifying, than attending an ultrasound to confirm a pregnancy after a long emotional fertility journey. But let’s not forget that ultrasounds are regularly performed in clinics to help fertility consultants diagnose fertility issues, track response to medication during IVF and monitor treatment progress, and they’re not solely used in female care alone – male infertility can also be investigated and diagnosed using these sonographic sound waves.

So, what are the different types of ultrasound scans Sonographers refer to in fertility care and what are their individual purposes? Let’s have a look…… 

Female Fertility Scans:

HyCoSy Scan - Fallopian Tube Assessment

A Hysterosalpingo-contrast-sonography, or HyCoSy for short, is a reliable and safe procedure used in infertility to determine whether a woman’s fallopian tubes are healthy. If either the tubes appear abnormal, or are damaged owing to conditions such as sexually transmitted infections (STIs), Endometriosis, or possibly even due to a previous medical surgery, this can lead to difficulties when trying to fall pregnant.

HyCoSy is a relatively quick procedure whereby a thin catheter is inserted transvaginally, into the uterus and a contrast agent is injected into the uterine cavity. If there are no tubal blockages, the agent can be seen passing through the tubes using the ultrasound.  

This scan is designed for women wanting to evaluate the status of their fallopian tubes if they are trying to get pregnant spontaneously, or following ovulation induction or IUI treatments.

When: Usually conducted between days 7-12 of a regular menstrual cycle.

Time Required: 30 mins 


3D Saline or Aqua Scan - Uterine Cavity Assessment

A 3D Saline Infusion Sonography or 3D Saline [3D-SIS] scan is usually conducted to enable a sonographer to easily assess the structure of the uterine cavity. 

It can be used to investigate congenital anomalies [meaning that your uterus formed in an unusual way before you were born and don’t worry - many women have a differently shaped womb but are unaware as there often aren't any symptoms], assess the cavity prior to and after any surgery, and to assist in the diagnosis of abnormal uterine bleeding, infertility and recurrent miscarriage. This procedure will also detect the presence of polyps, fibroids and scar tissue, which may all cause delays when trying to conceive spontaneously.

A detailed scan is performed using an ultrasound probe inserted through the vagina into the uterus, whilst saline solution is slowly injected into the uterine cavity to enable the sonographer to easily review images of the cavity for any anomalies.  

When: Usually conducted between days 7-12 of a regular menstrual cycle.

Time Required: 30 mins 



Advance Pelvic Scan - Gynaecological Assessment

A Pelvic Scan is an ultrasound investigation that is used to assess the structure within a woman’s pelvis. It is recommended for women with known or suspected complex gynaecological pathology such as fibroids, ovarian cysts, endometriosis, hydrosalpinx or other uterine anomalies.

This scan is usually performed transvaginally for optimum clarity although if the pathology is higher up in the abdomen, it can be performed abdominally.

When: Can be conducted any time in a cycle.

Time Required: 30 mins 


Ovarian Reserve Scan / Fertility Scan - Egg Reserve Assessment

This scan is usually conducted in the early part of the menstrual cycle to count the number of follicles in the ovaries. This antral follicle count [also known as an egg sac count] helps to assess ovarian reserve. The IVF Matters Fertility scan also involves a detailed analysis of the pelvic area to look at the size, shape and condition of the uterus, both ovaries and pelvic area. The scan is designed for women of child bearing age who want to evaluate their fertility status before fertility preservation or assisted conception treatments.  

When: Best performed between days 1-5 of a regular menstrual cycle.  

Time Required: 20 mins 



Monitoring Scans - Treatment Response Assessment

Monitoring Scans are vitally important for women undergoing either IVF or Egg Freezing Treatments, as they enable a fertility consultant to track the progress of changes within your uterus and ovaries in response to any prescribed fertility medications. This in turn, will highlight any problems or enable them to make a fully informed decision in relation to the next phase of your treatment, ie Egg Collection or Embryo Transfer.

When: Best performed at the start of a cycle and subsequently on days 6, 8, 10 and 12 of the cycle depending on the response to medication.  

Time Required: 20 mins 


Follicle Tracking Scans - Treatment Response Assessment

This scan is best suited for those wanting to assess their follicular and endometrial development in a natural cycle or in response to ovarian stimulation during ovulation induction treatment.

A detailed pelvic scan is performed to look at the uterus, along with the thickness and quality of the lining of the womb. The number and sizes of the ovarian follicles are also recorded.

When: Best performed at the start of a cycle and subsequently on days 6, 8, 10 and 12 of the cycle depending on the response to medication.  

Time Required: 20 mins 


Early Pregnancy / Viability Scan - Foetal Assessment

An early pregnancy scan can be performed to assess the number of embryos present following treatment or to provide reassurance that your pregnancy is progressing as it should if you have had any concerns.

An early pregnancy scan may be also useful for women who are experiencing pain or bleeding, or who have suffered previous miscarriages or ectopic pregnancies to reassure that the foetal sac is positioned well and that the pregnancy is viable. This scan is generally performed using a transvaginal probe to ensure clarity of the image.

When: Performed between 6-12 weeks gestation.

Time Required: 30 mins 


The type of ultrasound procedure performed, either transvaginally or abdominally, depends on the reason for the ultrasound. Only one method may be used where clarity and detail is required, or both methods may be needed to provide the information required for diagnosis or treatment.


Male Fertility Scans:

Scrotal Scans - Reproductive Organ Assessment

A scrotal ultrasound is a diagnostic test performed to assess the health of the male reproductive organs by examining the testes, the epididymis tubes and scrotal contents, along with other small organs, blood vessels and a small tube called the vas deferens.  

It can be used to diagnose lumps in the scrotum and evaluate possible causes of infertility, such as varicocele – when blood vessels become dilated and affect sperm quality.

This procedure is minimally invasive and is conducted by passing a hand-held probe over the skin of your scrotum to replicate on-screen imagery for review.  

When: Can be conducted any time.

Time Required: 30 mins 


Need an Ultrasound?

If you wish to schedule a Fertility Ultrasound through IVF Matters, the process is quite straight-forward and you can select our approved centres to find the one closest to you in the UK. 

Click here to book -  Ultrasound Scans  




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