Transvaginal ultrasound: A key tool in diagnosing endometriosis

If you’ve been experiencing symptoms such as pelvic pain, heavy periods or difficulty conceiving, you might already know these can be signs of endometriosis. Many patients struggle with the effects of this condition, and it can feel frustrating and overwhelming to seek a diagnosis. One of the most effective diagnostic tools is a transvaginal ultrasound (TVUS), a minimally invasive procedure that can provide a clearer picture regarding endometriosis and fertility planning.

What is a transvaginal ultrasound?

A transvaginal ultrasound is a type of imaging scan designed to give detailed views of your reproductive organs, including the uterus, ovaries and surrounding structures. During the procedure, a slender ultrasound probe is gently inserted into the vaginal canal. This allows us to get a much closer and clearer look than traditional abdominal ultrasounds, helping us spot abnormalities that may otherwise go undetected.

The procedure is relatively quick, and typically lasts around 15 to 30 minutes. While some patients may feel mild discomfort during the scan, it is generally well-tolerated and does not require any recovery time.

How can transvaginal ultrasound help diagnose endometriosis?

Endometriosis can be challenging to diagnose because its symptoms often overlap with other conditions, such as irritable bowel syndrome or pelvic inflammatory disease. A transvaginal ultrasound is particularly helpful for identifying certain forms of endometriosis, especially when the disease affects the ovaries or forms deep infiltrating nodules around structures like the bowel, bladder or pelvic ligaments.

For example, ovarian endometriomas (also known as "chocolate cysts") are a hallmark of endometriosis and are easily detected on a transvaginal ultrasound. Additionally, we can assess whether your uterus or ovaries appear immobile - a sign of adhesions, where tissues stick together due to inflammation caused by endometriosis. While not all forms of the disease are visible on ultrasound, the information it provides is invaluable in determining the next steps in your care.

How does a diagnosis help with fertility planning?

For patients trying to conceive, diagnosing and managing endometriosis is a crucial part of fertility care. Left untreated, endometriosis can impact your ability to become pregnant by affecting egg quality, ovulation or implantation. However, once identified, we can create a tailored treatment plan that may include medical therapies, surgery or assisted reproductive technologies like IVF, depending on your individual needs.

A transvaginal ultrasound also helps us monitor your ovarian reserve (the number and quality of eggs remaining in your ovaries), which is especially important for patients with endometriosis-related ovarian damage. Armed with this information, we can provide clearer guidance about your fertility options and timelines.

What are the next steps?

If you suspect you have endometriosis, or if you’ve been diagnosed but are unsure how it’s affecting your fertility, a transvaginal ultrasound is an excellent starting point. Combined with a detailed medical history and further investigation, if necessary, it provides the foundation for a comprehensive care plan tailored to your goals - whether that’s managing symptoms, preserving fertility, or achieving a successful pregnancy.

Endometriosis can feel isolating, but you don’t have to navigate it alone. By using advanced tools like transvaginal ultrasound, we can work together to better understand your condition and take proactive steps toward improving your health and quality of life.