Ultrasound technology revolutionized gynecological care over two decades ago, becoming an indispensable tool for diagnosing female reproductive issues. Today, it’s hard to imagine gynecology without it. Thanks to advancements, modern ultrasound devices offer transvaginal transducers with exceptional resolution, enabling clear visualization and precise tracking of pelvic organs.

So, when’s the best time for an ultrasound? Well, the uterus and ovaries are dynamic, changing throughout the menstrual cycle, requiring different exam times. Ideally, daily or every other day tracking would be perfect, but that’s not practical. Instead, specific days are chosen: the 5th-7th day, the 11th-13th day, and the 16th-18th day of the cycle.

During the early follicular phase (days 5-7), it’s prime time for pelvis examination. Measurements of the uterus, ovaries, and endometrium height (around 5-7 mm) are taken. Ovaries are checked for follicles, cysts, or growths.

Around ovulation (days 11-13), the ovaries undergo folliculogenesis, ovulation, and steroidogenesis. Follicles develop, and one dominant follicle emerges, rupturing during ovulation, leaving behind a corpus luteum.

Between days 16-20, after ovulation, not much changes in the uterus, but the dominant follicle disappears, and there’s a bit of fluid behind the uterus, indicating ovulation.

Ultrasound also reveals different types of endometrium. L-mucosa appears in the early follicular phase, followed by M-mucosa in the mid-cycle with estrogen stimulation, and S-mucosa with progesterone production.

No specific preparation is needed for ultrasound, but knowing menstrual cycle details is essential. The exam typically starts with external genitalia examination, followed by speculum insertion to view the vagina and cervix, vaginal douching, and abdominal palpation. For transabdominal ultrasound, a full bladder is necessary, while for transvaginal, an empty bladder is preferred. Though transvaginal exams may be uncomfortable, they’re not painful, and maintaining cleanliness is ensured by using a condom on the transducer.