Transvaginal Ultrasound

What Is a Transvaginal Ultrasound?

An ultrasound test uses high-frequency sound waves to create images of your internal organs. Imaging tests can identify abnormalities and help doctors diagnose conditions. A transvaginal ultrasound is a type of pelvic ultrasound used by doctors to examine female reproductive organs. This includes the uterus, fallopian tubes, ovaries, cervix, and vagina.

“Transvaginal” means “through the vagina.” This is an internal examination. Unlike a regular pelvic ultrasound, where the ultrasound wand rests on the outside of the pelvis, this procedure involves your doctor or a technician inserting an ultrasound probe about two or three inches into your vaginal canal.

When Is a Transvaginal Ultrasound Performed?

There are many reasons a transvaginal ultrasound might be necessary, including: 

  • an abnormal pelvic or abdominal exam
  • unexplained vaginal bleeding
  • pelvic pain
  • an ectopic pregnancy (which occurs when the fetus implants outside of the uterus, usually in the fallopian tubes)
  • infertility
  • checking for cysts or uterine fibroids
  • checking for proper placement of an IUD 

Your doctor might also recommend a transvaginal ultrasound during pregnancy to:

  • monitor the heartbeat of the fetus
  • look at the cervix for any changes that could lead to complications such as miscarriage or premature delivery
  • examine the placenta for abnormalities
  • identify the source of any abnormal bleeding
  • diagnose a possible miscarriage

How Should I Prepare for a Transvaginal Ultrasound?

In most cases, a transvaginal ultrasound requires little preparation on your part. Once you’ve arrived at your doctor’s office or the hospital and you’re in the examination room, you will have to remove your clothes from the waist down and put on a gown.

Depending on your doctor’s instructions and the reasons for the ultrasound, your bladder might need to be empty or partially full. A full bladder helps lift the intestines and allows for a clearer picture of your pelvic organs. If your bladder needs to be full, you’ll have to drink 32 ounces of water or any other liquid about 30 minutes to one hour before the procedure begins. 

If you’re on your menstrual cycle or if you’re spotting, you’ll have to remove any tampon you’re using before the ultrasound.

What Happens During a Transvaginal Ultrasound?

When it’s time to begin the procedure, you’ll lie down on an examination table and place both of your feet in stirrups. Your doctor will cover the ultrasound wand with a condom and lubricating gel, and then insert the wand into your vagina.

You might feel some pressure as your doctor inserts the wand. This feeling is similar to the pressure felt during a pap smear when your doctor inserts the speculum into your vagina. Once the wand is inside of you, sound waves bounce off your internal organs and transmit pictures of the inside of your pelvis onto a monitor. The technician or doctor will slowly move the wand around while it’s still inside of your body. This provides a comprehensive picture of your organs. 

Saline infusion sonography (SIS) is a special kind of transvaginal ultrasound that involves inserting sterile salt water into the uterus beforehand to help identify any possible masses. The saline solution stretches the uterus slightly, providing a more detailed picture of the inside of the uterus than a conventional ultrasound. Although a transvaginal ultrasound can be done on a pregnant woman, SIS cannot.

What Do the Results Show?

You might get your results immediately if your doctor performs the ultrasound. If a technician performs the procedure, the images are saved and then analyzed by a radiologist. The radiologist will send the results to your doctor. 

A transvaginal ultrasound helps diagnose multiple conditions, including:

  • cancer of the reproductive organs
  • cysts
  • fibroids
  • pelvic infection
  • ectopic pregnancy
  • miscarriage
  • placenta previa (a low-lying placenta during pregnancy that may warrant medical intervention)
  • fetal birth defects

Talk with your doctor about your results and what type of treatment, if any, is necessary.


There are virtually no risks associated with a transvaginal ultrasound, although you might experience some discomfort. The entire test takes about 30 to 60 minutes, and the results are typically ready in about 24 hours. If your doctor is unable to get a clear picture, you might be called back to repeat the test.

If you experience too much discomfort from a transvaginal ultrasound and can’t tolerate the procedure, your doctor may perform a transabdominal ultrasound. This involves your doctor applying gel to your stomach and then using a hand-held device to view your pelvic organs. This approach is also an option for pediatric patients when pelvic images are needed.

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