TVUS

Transvaginal ultrasound (TVUS) is a pelvic imaging modality in which a high-frequency transducer is inserted into the vagina to obtain real-time images of the uterus, ovaries, fallopian tubes (where visible), and adjacent pelvic structures. The examination is typically performed with the patient in the supine position, using a protective sheath and ultrasound gel. The transducer provides higher-resolution images than transabdominal ultrasound, allowing closer visualization of endometrial lining, ovarian follicles, and adnexal structures. Doppler options may be used to assess blood flow.

Indications include assessment of early pregnancy and dating, evaluation of vaginal bleeding or pelvic pain, infertility workups (including ovarian reserve and follicular development), monitoring follicular growth during stimulation for assisted reproduction, and characterization of uterine fibroids, polyps, endometrial abnormalities, or adnexal masses. TVUS is also used to guide certain gynecologic procedures and to evaluate suspected ectopic pregnancy in appropriate clinical settings.

Safety and limitations: TVUS is noninvasive and does not involve ionizing radiation. Complications are rare. Potential drawbacks include brief discomfort, embarrassment, and vaginal irritation. Some patients, such as those who are virginal or have certain vaginal conditions, may decline the examination or require alternative imaging. Visualization may be limited by body habitus or pelvic gas, in which case transabdominal ultrasound or MRI may be used as complementary imaging.