Ultrasound of the ovaries on what day. How is ultrasound of the appendages and uterus performed? Organs examined and indications for pelvic ultrasound

Ultrasound examination is popular due to its informativeness, reliability of results and painlessness. When choosing between other non-invasive procedures, ultrasound wins due to its minimal health risks. To date, any immediate and long-term consequences are unknown to medical science. This is a very important point when conducting research on a woman’s reproductive organs.

Ultrasound of the uterus and appendages has virtually no contraindications and can be performed at any period of a woman’s life, including during pregnancy. The procedure requires little preparation.

Indications

The indications for this procedure are numerous. But they can be divided into three main groups:

1. Diagnosis of diseases.
2. Diagnosis of pregnancy.
3. Management of pregnancy and childbirth.

The first group includes ultrasound examination of the uterus and appendages, associated with the appearance of discomfort and pain in the pelvic area:

• Cycle failures.
• Bloody discharge during menstruation.
• Copious mucous or purulent discharge.
• Nagging pain in the lower abdomen.
• Pain, cutting, burning when urinating.
• Discomfort during intercourse.

The doctor prescribes an ultrasound if there is a suspicion of inflammatory processes affecting a woman’s reproductive organs or if there is a suspicion of the growth of tumors of varying degrees of malignancy. This test can help identify abnormal implantation of the embryo (ectopic pregnancy).

In case of infertility, ultrasound can help identify an organ abnormality that interferes with conception or a violation of the patency of the fallopian tubes. Ultrasound allows you to confirm or refute the doctor’s assumption in doubtful situations. The same study is used to monitor the results of surgical interventions or monitor the effectiveness of drug therapy.

An ultrasound examination of the uterus is prescribed by an obstetrician-gynecologist to confirm the fact of pregnancy, along with a blood test for hCG. If a woman’s previous birth resulted in a caesarean section, then the scar needs to be examined. Scar tissue is assessed for its consistency in the third trimester of gestation. This allows you to take timely action if the fabric begins to “diverge.”

Ultrasound diagnostics are allowed at any stage of pregnancy. The number of procedures is limited only by necessity.

During pregnancy, this study is carried out at least 3 times to confirm the normal development of the fetus and the optimal state of the uterus-placenta-fetus system. After pregnancy, an ultrasound is performed to assess the condition of the uterus and its contractility. The procedure allows you to assess the contents of the uterus (number of clots) and its condition (signs of inflammation, if any).

If the pregnancy is resolved promptly, an ultrasound examination allows you to assess the quality of healing of the postoperative scar and detect complications in time, for example, the formation of abscesses or fistulas.

Kinds

Types of examination of a woman’s reproductive organs are divided according to the method of conducting them:

• Transabdominal.
• Transvaginal.
• Transrectal.
• Intrauterine.

A transabdominal examination (TAU) is performed through the abdominal wall. It is less informative than other methods. Especially if the patient is obese. The voluminous abdominal wall impairs the visualization of the genital organs. An unprepared intestine filled with gases can also affect the effectiveness of the procedure.

The advantage of the procedure is the possibility of carrying it out:

• For virgins.
• Women at any stage of pregnancy.
• In case of obstruction of the cervical canal or its injuries.
• Severe pain during the transvaginal procedure.

Transvaginal ultrasound (TVU) is done using a special vaginal transducer (sensor). It is inserted into the vagina, and due to the proximity of the sensor to the organs being examined, the doctor can see the picture more clearly. This procedure is considered more reliable than the previous one, but is not performed on either virgins or pregnant women from the end of the first trimester.

Transrectal examination (TRS) is performed quite rarely to examine a woman’s reproductive organs. For these purposes, a special rectal sensor is used, which is inserted into the rectum. This option makes it possible to conduct a study in cases where TAU was not sufficiently informative, and TVU cannot be performed for some reason (virginity, pregnancy, stenosis or fusion of the walls of the cervical canal, etc.).

Intrauterine examination is prescribed in exceptional cases, for example, to verify a diagnosis suggesting the development of intrauterine tumors. In this case, the sensor is immersed directly into the uterine cavity. The procedure is very informative, because there are no obstacles between the organ being examined and the sensor. In addition, it allows you to assess the patency of the fallopian tubes.

Carrying out

Women who are prescribed this type of diagnosis are interested in how an ultrasound of the uterus is done. The procedure is quite simple for any type of study, it takes no more than half an hour, on average 20 minutes.

The most comfortable procedure is a transabdominal ultrasound. In this case, the woman lies on her back, exposing her stomach. The doctor lubricates the skin with a special gel for better contact of the area being examined with the sensor. And then moves the sensor across the study area. This is the whole procedure.

Ultrasound of the uterus and appendages performed using the transvaginal method is a less comfortable procedure. To perform it, a woman will have to expose her lower body. She will also lie on her back, but the specialist will insert a special vaginal sensor into the vagina. A condom is placed over the sensor. This provides the woman with confidence that foreign microflora will not enter her vagina.

For an ultrasound of the uterus and ovaries, which is performed through the rectum, the woman will have to lie on her side. It exposes the lower part of the body in the same way as for TVU. A condom is also placed on the sensor. It is lubricated with gel, which facilitates the sliding of the device and reduces discomfort. The sensor used for these purposes is smaller in size (narrower) than the device for TVU.

Ultrasound of the uterus and appendages, performed intrauterine, is somewhat different from other procedures, and somewhat more difficult to perform:

• The patient undresses, as if for a gynecological examination, and lies on her back.


• She must place her feet in special stirrups.
• The cervix is ​​dilated using a speculum, then a catheter is inserted, the speculum is removed and the transducer is inserted into the uterine cavity. A catheter is needed so that saline solution can be injected into the uterus. This helps to straighten the folds of the endometrium and better examine the organ.
• To assess the patency of the fallopian tubes, saline solution is injected with air. It is easy for a doctor to determine their patency by the movement of bubbles through the pipes.
• The study will be done on average within half an hour.

Time spending

Unlike ultrasound examination of any other organs, the information content of ultrasound of the uterus and other reproductive organs directly depends on the day of the cycle, and on how correctly the woman named it. It is recommended to conduct research:

• With the development of acute pathology - on the day the first symptoms are felt (pain, appearance of purulent discharge, etc.).
• Routine diagnostics are carried out on days 3–10 of the menstrual cycle.

It is better to conduct the study at the very beginning of the cycle on days 3–5.

During this period, the mucous uterine layer (endometrium) has not yet had time to grow, and it is easier for the doctor to see the polyp or tumor. In this case, differential diagnosis of cystic formations is more successful.

Preparation

The scope of preparatory measures depends on the type of procedure. A minimum of preparation is required for diagnostics using the intrauterine method - it is enough to come to the examination with an empty bladder.

Preparation for an ultrasound of the uterus, which is performed through the abdominal wall, requires dietary restrictions. 24 hours before the test, it is recommended to exclude all gas-forming foods from your menu, from carbonated drinks to legumes and black bread. If a woman suffers from flatulence, carminatives (Semiticon, Espumisan) are recommended.

You need to go to the test with a full bladder. To do this you should:

• Drink 1 liter of clean water without gas and refrain from visiting the toilet.
• Or does not urinate for 3 hours before the procedure.

It is recommended to carry out the procedure on an empty stomach. Diet restrictions will also be necessary for other types of ultrasound diagnostics. They are needed to prevent gas bubbles from accumulating in the intestines. Air (gas) may interfere with imaging.

When conducting a TVU study, if a woman suffers from flatulence, she should also take carminatives. Before the examination, the bladder must be emptied.

When learning how to prepare for an ultrasound of the uterus during TRU, a woman needs to take into account that the sensor will be inserted into the rectum. That is, the intestinal ampoule should be as clean as possible. To do this, 8 hours before the procedure you need to take a microenema (Norgalax) or drink a laxative (Sanade).

Decoding

The description of the results and their interpretation is the prerogative of the doctor. Ultrasound examination allows you to evaluate the anatomical features of the reproductive organs. Interpretation of the results includes a description of the size of the genital organs, their condition, the presence of pathological structures or signs of inflammation.

The cervical canal should normally have a diameter of about 3 mm. And signs of mucus should be visualized in it. The size of the uterus depends on the age of the woman. After menopause, the organ becomes slightly smaller:

• Length 4.5–6.7 cm.
• Width 4.6–6.4 cm.
• Thickness 3–4 cm.

If the uterus is smaller than the specified dimensions, this indicates its underdevelopment (infancy); if the dimensions exceed the specified size, the woman is either pregnant or has fibroids growing in her uterus.

Ultrasound diagnostics makes it possible to determine the thickness of the endometrium. Indicators are variable and depend on the day of the cycle. In the first days, the thickness barely reaches a millimeter, in the middle of the cycle the endometrium should be about 8–15 mm, and by the end of the cycle the mucous membrane grows to 17 mm.

Interpretation of the ultrasound examination also involves a description of the ovaries. The volume of these organs ranges from 2 to 8 cm3. According to the echo structure, healthy ovaries should give a homogeneous signal. Their dimensions are also quite definite:

• Thickness 0.14–0.22 cm.
• Length – 3–4.1 cm.
• Width – 2–3.1 cm.

Changes in the size of the organ, the quality of the echo signal, and contours are all visual signs of various pathologies.

Thanks to ultrasound, it is possible to diagnose polycystic ovary syndrome and inflammatory processes in these organs (salpingitis). Cancerous changes in the tissues of the cervix, ectopic pregnancy and other pathologies are also visible.

According to the generally accepted rule, an ultrasound of the uterus is performed 3-5 days after menstruation. If you count from the beginning of the cycle, then the examination should be carried out no later than the 10th day of the menstrual cycle.

Compliance with the timing of menstruation is important because in the first phase the lining of the uterus (endometrium) is thinner, which allows it to be examined in detail. Thanks to this, the doctor can detect modifications of the mucosa, fibroids, polyps, tumor neoplasms and other pathologies of the uterus at preclinical stages. If diagnostics are carried out in the second half of the monthly cycle, the endometrium becomes thicker and visualizing pathological changes in the mucous membranes becomes much more difficult. In addition, compliance with this rule is due to the course of cyclical changes that occur in the body. And the results of the study will depend on what day the examination was carried out.

Taking into account what day of the cycle the ultrasound of the uterus was performed, the following changes are indicated in the protocol:

• Regeneration phase (3-4 days) - restoration of endometrial cells after the end of menstruation;
• Proliferation phase (5-14 days) - gradual thickening of the uterine mucosa;
• The secretory phase of the cycle (starting from day 15) is the maximum development of the endometrioid glands, which indicates the preparation of the uterus to receive the egg.

To obtain reliable diagnostic results, ultrasound of the uterus is performed on certain days of the menstrual cycle. The optimal time for performing the study is determined by the doctor, taking into account the age, condition and complaints of the patient.

In any case, the time for an ultrasound scan of the uterus is determined by the doctor on an individual basis. This takes into account the age, characteristics and condition of the patient, as well as the goals of the study and the presence of pathological symptoms.

Ultrasound of the uterus and appendages - on what day of the cycle should the procedure be performed for patients of different age categories

Gynecological pathologies can appear at any age, so ultrasound scanning of the uterus is performed on women of different age categories:

• For girls who have not yet menstruated, an ultrasound examination of the uterus can be prescribed on any day. If the patient has had menstruation, the doctor should take into account the time of its onset and perform an ultrasound within the usual time frame;
• For women who have entered menopause, ultrasound diagnostics are also performed at any time, since the endometrium does not change as often as in patients of reproductive age;
• In women with an irregular menstrual cycle, the day of the ultrasound is determined by the doctor after studying complaints and anamnestic information;
• For pregnant women, ultrasound examination is prescribed 3 times in each trimester (in the absence of pregnancy pathologies).

For patients of reproductive age, an ultrasound examination of the uterus is performed taking into account the day of the menstrual cycle. If there are the following indications, ultrasound diagnostics is carried out in the first days after the end of menstrual flow:

• Inflammatory processes of the uterine cavity;
• Tumors of different stages of development, degree of malignancy and localization;
• Uterine fibroids;
• Onset of pregnancy;
• Ovarian dysfunction;
• Cysts in the uterus.

In addition, an ultrasound of the uterus may be performed during menstruation. Conducting research during this period allows reproductive specialists (in preparation for in vitro fertilization) to determine the number of follicles in the ovaries.

Some women experience slight bleeding for 3-5 days. Patients need not worry about this. Their presence is not a limitation to the study. In such a case, you need to have a tight gasket with you.

Ultrasound of the uterus is a safe and painless diagnostic method that can be recommended to women on any day of the cycle. Using this technique, it is possible to detect various pathologies in the early stages and carry out appropriate treatment. It is important for women not to ignore routine examinations and regularly visit a gynecologist. Only a doctor can tell when it is best to conduct a study after a preliminary consultation and gynecological examination.

Ultrasound of the uterus and appendages is a simple and effective way to obtain a sufficient amount of information about a woman’s reproductive organs. Due to its availability, it has gained wide popularity among the population. The method is considered absolutely safe, therefore it is actively used in diagnosing pregnancy and assessing its development during screening studies.

Teratogenic or other effects of ultrasound on the fetus have not been proven. Ultrasound examination of the female reproductive organs is used both for routine examination and for diagnosing emergency conditions. However, despite all the advantages of the method, it is necessary to understand that its capabilities are limited. In addition, you need to carefully prepare for the study and make the right choice of its date in the context of the menstrual cycle. Compliance with these requirements allows you to reduce the risk of diagnostic errors and increase the effectiveness of the method.

When is ultrasound indicated?

Ultrasound of the uterus and ovaries is used to diagnose diseases of a woman’s reproductive organs, for follow-up examinations after therapy, to monitor pregnancy, and for other purposes. The scope of application of this method is quite wide.

A pelvic ultrasound should be ordered by your doctor. However, there are times when it is impossible to get to the doctor, then knowledge of when implementing this method can help can come to the rescue. An ultrasound of the female genital organs may be performed if:

• pain of varying nature and intensity in the pelvis;
• before the in vitro fertilization procedure;
• diagnosis of pregnancy and determination of its duration;
• checking the patency of the fallopian tubes;
• polyps and endometrial hyperplasia;
• large blood loss during menstruation;
• prolonged menstruation;
• bloody or brown discharge between periods;
• neoplasms of the uterus and appendages;
• screening studies during pregnancy;
• complaints during pregnancy;
• ovarian dysfunction;
• infertility.

What is the essence of the procedure

An ultrasound of the pelvic organs is performed while lying on your back on a couch. The light in the office is dim for better visualization of the picture on the screen. The procedure varies slightly depending on the examination method chosen. Currently, there are 4 types of ultrasound examination of female reproductive organs:

• transabdominal,
• transvaginal,
• transrectal,
• intrauterine.

When performing transabdominal ultrasound, the ultrasound sensor is placed on the anterior abdominal wall. The study is carried out using a special gel that improves ultrasound performance. This method is actively used in the second and third trimesters of pregnancy, in women who are not sexually active, and also to identify gross gynecological pathology.

Transvaginal ultrasound obtains the necessary information using a sensor inserted into the vagina. This procedure is painless, but a woman may feel discomfort during it. To reduce discomfort, the patient is advised to relax. Transvaginal ultrasound is used to diagnose ectopic pregnancy, during short gestation, for endometrial polyps, endometriosis and other gynecological pathologies. There is no need to be afraid of transmission of infection, since a condom is used during the examination.

In difficult diagnostic situations, transrectal and intrauterine ultrasound are used.

How to prepare

Compliance with all the rules of preparation for ultrasound examination of the uterus and appendages is necessary to obtain reliable results. The mandatory conditions vary and depend on the type of ultrasound used:

1. 1-2 hours before the transabdominal examination, you need to drink 1-1.5 liters of water in order to fill the bladder. The woman should have a moderate desire to urinate.
2. If your doctor has prescribed a transvaginal ultrasound, it is advisable to go to the toilet before the procedure.
3. An enema is recommended before transrectal ultrasound.

Excluding products that increase gas formation two days before the examination is necessary for any examination method.

• These products include:
• baking;
• legumes;
• black bread;

raw vegetables and fruits.

The effectiveness of the examination depends on which day of the cycle an ultrasound of the uterus is performed. A woman's reproductive organs work in a cyclical mode. This determines the timing of the survey. The doctor, depending on what he wants to see with the help of the study, chooses the day for it individually for each woman. The main selection criterion here is the purpose of the study.

• On the 2-3 third day of the menstrual cycle, an ultrasound is recommended to assess the ovarian reserve. Most often, this is necessary before using assisted reproductive technologies. In most cases, performing an examination during menstruation is undesirable. Ultrasound during this period is difficult and can cause diagnostic errors.
• The best time to perform an ultrasound examination of the female genital organs is the 5-7th day of the menstrual cycle. During this period, the results of ultrasound of the uterus are the most informative. There are several reasons for this. On the 5-7th day, the thickness of the internal mucous layer of the uterus is still small, which creates favorable conditions for diagnosing formations in the uterine cavity (polyp, submucosal uterine fibroids). At the same time, follicle growth in the ovaries is just beginning. The dominant follicle will begin to be determined a little later. Therefore, this time is considered the best for diagnosing pathology of the appendages (ovarian cysts and neoplasms).
• When performing folliculometry after an ultrasound following menstruation, a follow-up examination is carried out on the 10th day of the cycle. The goal at this point is to record the dominant follicle, which reaches a size of up to 25 mm in diameter. Next, the study is repeated every 2 days in order to register ovulation by such signs as the disappearance of the dominant follicle and the appearance of a small amount of fluid in the retrouterine space.
• When performing an ultrasound in the second phase of the menstrual cycle, the condition of the endometrium and the corpus luteum are assessed. Sufficient thickness of the inner mucous layer of the uterus in combination with a well-functioning corpus luteum ensures successful implantation of the egg and the development of pregnancy. In case of emergency situations (bleeding, suspected ectopic pregnancy, cyst rupture, ovarian apoplexy, etc.), the examination is carried out urgently on any day of the menstrual cycle.
• To diagnose pregnancy, it is recommended to do an ultrasound on the 7-10th day of the delay, so that the fertilized egg has time to descend into the uterine cavity and the embryo has become large enough to be visualized during examination.

What can an ultrasound tell you?

An ultrasound scan of the uterus can only be interpreted by the attending physician. The same study results in different women can indicate both normality and pathology. In addition to the day of the menstrual cycle, it is necessary to take into account the woman’s age, taking hormonal medications, etc.

The size of the uterus is individual for each woman and is determined by age (from the onset of puberty, the uterus increases, and when the amount of hormones during menopause decreases, subinvolution of the organ is observed), the number of births and pregnancies in the history. The organ enlarges with fibroids, adenomyosis and pregnancy and decreases with infantilism.

The endometrium according to ultrasound should correspond to the day of the menstrual cycle. M-echo in the menopausal period should be linear or not exceed 4 mm in thickness, otherwise this may indicate endometrial hyperplasia, endometrial tumor.

Ultrasound of the cervix allows you to evaluate its structure and features of the cervical canal. Using these data, it is possible to diagnose inflammatory processes and polyps of the cervix, and isthmic-cervical insufficiency during pregnancy. Examination of the appendages helps identify cysts, neoplasms, and ectopic pregnancy.

How is an ultrasound of the fallopian tubes performed?

The patency of the fallopian tubes can be checked by ultrasound using a contrast agent. This research method is called “ultrasound metrosalpingography”. The examination is carried out after menstruation on days 7-12 of the cycle.

For a woman on a gynecological chair, a thin and flexible catheter is inserted into the uterine cavity. A warm, sterile solution of contrast agent flows through it. On the monitor screen, the doctor observes how the solution is evenly distributed in the uterine cavity and fallopian tubes. The appearance of contrast fluid in the retrouterine space indicates patency of the fallopian tubes.

Why do you need a gynecological ultrasound with colorectal dosage?

Color Doppler Imaging stands for Color Doppler Imaging. Ultrasound using this method allows you to register different speeds of blood flow. Ultrasound examination with color circulation gives an assessment of blood flow in the uterine and ovarian arteries, in the endometrium, appendages and pathological formations. It is actively used for the diagnosis of neoplasms and inflammatory processes of the female genital organs, as well as during pregnancy.

Usually, ultrasound of the ovaries in women is performed in conjunction with other studies, but in some cases it can be prescribed by a doctor as an independent procedure.

What does every woman need to know when preparing for such an examination?

The ovaries are a paired organ that provides the hormonal background necessary to maintain reproductive function and the formation of an active egg capable of fertilization. It is the activity of the ovaries that determines the female menstrual cycle and affects the general condition of the body.

Often, gynecological ultrasound of the ovaries and ovaries is prescribed to monitor their functional activity. The fact is that the structure of these organs undergoes cyclical changes every month: follicles appear, from which the dominant one develops, forming the egg, hormones are synthesized, ovulation and the development of the corpus luteum occur.

All these processes are perfectly visualized during the examination and allow the doctor to find out how fully the patient’s ovaries “work.”

A gynecologist gives a referral for an ultrasound scan of the ovaries at the slightest suspicion that any pathological processes or hormonal disorders are occurring in a woman’s body.

• irregular menstrual cycle, missed periods;
• painful menstruation;
• excessively heavy or scanty bleeding, discharge of blood outside of menstruation;
• diseases of the mammary glands (mastopathy, neoplasms);
• suspicion of inflammatory processes in the appendages;
• complaints of pain in the lower abdomen;
• suspicions of the presence of neoplasms;
• monitoring in preparation for IVF;
• dynamic observation of ovarian functions;
• absence of planned pregnancy;
• screening observation of women's health (prevention of disease development).

The risk of developing diseases of the reproductive system can be significantly reduced if you are regularly examined by a gynecologist. Doctors recommend that every healthy woman undergo an annual ultrasound examination in order to notice abnormalities in time and prevent the occurrence of pathologies.

How to do an ultrasound of the ovaries: methods of conducting

There are three ultrasound methods for checking the ovaries in women: transabdominal, transvaginal and transrectal. Let's consider each method in detail.

Transabdominal - ultrasound is performed through the abdominal wall using an external sensor. This method is now used less and less, because... involves significant preparation of the patient for the procedure. If the preparation is poor, the reliability of the results is distorted.

Transvaginally - since the accuracy of this type of ultrasound data is much higher, and there is no need for preparation on the part of the patient, this method is a priority in modern clinics. A narrow probe is inserted through the vagina upward towards the cervix, providing maximum possible access to the pelvic organs.

There is also a transrectal method, but it is used extremely rarely, in exceptional cases (for example, in virgins).

How to prepare for an ovarian ultrasound

Preparation for an ovarian ultrasound in women is of great importance. Although there are no special restrictions on diet, medications or health conditions, a woman should take into account the following rules.

Ultrasound of the ovaries should be performed on certain days of the monthly cycle.

• In order to assess their morphological condition and check for the presence of pathologies, it is necessary to do an ultrasound immediately after the end of menstruation, on days 5–7 of the cycle.
• In order to determine their functional activity, the study should be carried out on the days recommended by the attending physician. The fact is that during the course of a month, reproductive processes occur in a woman’s body, which have 4 phases of development. To determine the causes of infertility or hormonal imbalance, it is often necessary to observe the condition of the organ in each of these phases.

With transabdominal access, the bladder should be filled as much as possible.

An hour and a half before the test, you should drink 1–1.5 liters of still water or tea. The bladder, filled with water, conducts ultrasound well to the ovaries, which are located behind it.

If the bladder is not full enough, the doctor may not “examine” the organs of interest properly. It is not recommended to have a bowel movement before the end of the procedure - this may affect the reliability of the results.

No special preparation is required for transvaginal ultrasound.

The most important thing a woman should take care of is personal hygiene products. For individual protection against infections, a special condom is placed on the sensor.

Typically, diagnostic rooms are fully equipped with such disposable products, but sometimes, in their absence, the patient is asked to purchase the product herself. The product is called “Condom for Ultrasound” and is sold in all pharmacies.

Note: If a woman has a severe allergy to latex, you should notify your doctor in advance.

Before transrectal ultrasound, it is necessary to clear the rectum of feces.

To do this, on the eve of the appointment, the girl must do a small enema (300–350 ml of water). You should also ensure that there are no gases in the intestines - do not eat foods that stimulate their formation the day before (fruits, vegetables, sweets, brown bread, legumes, carbonated drinks).

How is the ovarian ultrasound procedure performed?

• Ultrasound examination of the ovaries using transabdominal access - the patient lies on the couch with her back down, freeing the groin area and abdomen from clothing. The doctor generously lubricates the surface of the skin with gel in order to ensure better contact of the external sensor with the body. The device is moved over the skin with slight pressure.
• For transvaginal access, it is necessary to take the position necessary for optimal insertion of the sensor - lie on your back with your knees bent. The device is quite narrow and does not cause any discomfort - the procedure is completely painless.

In order to fully examine both ovaries, an ultrasound diagnostic specialist will need 10–15 minutes.

Standards for ovarian examination results

During the examination, the doctor determines the position, size and structure of the ovaries.

The normal position of the ovaries is on the sides of the uterus and somewhat posteriorly. It is because of their adherence to the uterus that they received the informal name of appendages. During pregnancy, these organs move upward.

The size of the ovaries can vary depending on the day of the menstrual cycle, the woman’s age, the number of full-term and terminated pregnancies, the use of oral contraceptives and the individual characteristics of the body. The following parameters are considered normal for a woman of reproductive age:

• volume – from 4 to 10 cm3;
• length – from 20 to 37 mm;
• width – from 18 to 30 mm;
• thickness – from 16 to 22 mm.

In most women, the right and left ovaries differ in size. However, a significant difference in volume may indicate the presence of pathology or a congenital anomaly. An increase in size may indicate polycystic syndrome or oophoritis.

The structure of the ovaries depends on the day of the menstrual cycle - the doctor determines the size and number of follicles, the presence of a dominant follicle, the corpus luteum, and examines for cysts and tumors.

A discrepancy between the structure and the norm may indicate polycystic disease (many undeveloped follicles), late ovulation, functional disorders and pathologies.

The normal size of the ovaries according to ultrasound depends on the day of the study:

• Days 5–7: 5–10 follicles in the cortex, ranging in size from 2 to 6 mm;
• 8–10 days: 5–9 follicles no more than 10 mm and 1 dominant, 12–15 mm;
• 11–14 days: dominant follicle 16–20 mm, ovulation – when it reaches 18 mm;
• Days 15–18: (15–20 mm) at the site of the ovulated follicle;
• 19–23 days: the corpus luteum gradually reaches a size of 25–27 mm;
• 24–27 days: the corpus luteum regresses to 10–15 mm;
• menstruation: the corpus luteum disappears.

The contours of healthy appendages should be uneven, but clear. Blurred boundaries may indicate inflammation.

In acute cases, ultrasound is also performed during menstruation - the procedure is absolutely safe and cannot lead to any complications.

Ultrasound of the uterus is the most accessible test for identifying gynecological diseases. This procedure provides accurate data on the anatomical features of the internal genital organs (the structure of the uterus) and allows you to diagnose even minimal deviations.

Indications

For the following symptoms and suspicions of disease, the attending physician must prescribe an ultrasound:

• Infertility;
• Prolonged menstrual flow, irregular cycle, delayed menstruation;
• Pain in the lower abdomen;
• Endometriosis, endometritis;
• Polycystic ovary syndrome, salpingitis, ovarian torsion, ovarian cyst and its torsion;
• Ectopic pregnancy.

Preparation for the procedure

Since the thickness of the uterine endometrium may change throughout the menstrual cycle, it is better to perform an ultrasound on days 5-7 from the first day of menstrual flow. Find out in advance what type of ultrasound you will undergo - transvaginal through the vagina and transabdominal through the abdomen. In the second case, you need to drink a liter of water two hours before the procedure and not visit the toilet before it, since it is necessary to clearly distinguish the bladder to distinguish it from the uterus.

For transvaginal ultrasound, be sure to empty your bladder before the procedure, otherwise you may experience discomfort as the probe is inserted deep into the vagina.

Carrying out the procedure

Features of the procedure directly depend on the method - transvaginal or transabdominal ultrasound. Both procedures are safe and do not cause pain.

• The transvaginal method demonstrates more accurate data and is highly sensitive. A small sensor is inserted into the vagina, which will read the image and transmit it to the screen.
• Transabdominal ultrasound involves applying a special gel to the lower abdomen, which increases the sensitivity of the transducer to read ultrasound through the skin.