Transvaginal Ultrasound: Pregnancy, Purpose & Cost

by | Sep 3, 2023 | Pregnancy

What is a Transvaginal Ultrasound?

A Transvaginal Ultrasound, also known as transvaginal sonography or endovaginal ultrasound, is a diagnostic imaging procedure that involves the use of high-frequency sound waves to create detailed images of the female reproductive organs, including the uterus, ovaries, fallopian tubes, and cervix. Unlike traditional ultrasound, which is performed externally on the abdominal area, TVS involves inserting a specially designed ultrasound probe into the vagina. This probe emits sound waves, which bounce off internal structures and are converted into real-time images, providing a close-up view of the pelvic region.


Transvaginal Ultrasound Procedure

The Transvaginal Ultrasound procedure typically follows these steps:

  1. Preparation: Patients are usually asked to empty their bladder before the procedure to enhance image quality.
  2. Positioning: The patient is positioned on an examination table, similar to a pelvic exam, and a protective cover is placed over the probe.
  3. Probe Insertion: A lubricated and covered ultrasound probe is gently inserted into the vagina.
  4. Imaging: The probe emits sound waves and receives echoes, generating images displayed on a monitor. The healthcare provider adjusts the probe to capture specific angles and structures.
  5. Data Capture: The ultrasound machine records the images for analysis and future reference.
  6. Completion: After obtaining the necessary images, the probe is removed, and the procedure concludes.


How Transvaginal Ultrasound Differ from Traditional Ultrasound?

The primary difference between Transvaginal Ultrasound and traditional ultrasound lies in the approach and the organs examined:

  • Approach: TVS involves the insertion of a probe into the vagina, allowing for close proximity to the pelvic organs. In contrast, traditional ultrasound is conducted externally on the abdominal surface.
  • Organs Examined: TVS is specifically designed for examining the female reproductive organs, providing detailed views of the uterus, ovaries, and cervix. Traditional ultrasound, on the other hand, is more versatile and can assess a broader range of structures throughout the body.


Purpose of Transvaginal Ultrasound

Medical Conditions Diagnosis and Monitoring

Transvaginal Ultrasound serves several critical purposes in the realm of women’s health:

  1. Pregnancy Confirmation: One of its primary uses is to confirm and monitor pregnancies. TVS can detect a gestational sac as early as 4 to 5 weeks into pregnancy, providing essential information about fetal development.
  2. Fertility Assessment: It aids in evaluating the reproductive system, and identifying conditions such as polycystic ovary syndrome (PCOS), uterine fibroids, or structural abnormalities that may affect fertility.
  3. Pelvic Pain Diagnosis: TVS is instrumental in diagnosing the causes of pelvic pain, such as ovarian cysts, endometriosis, or pelvic inflammatory disease.
  4. Abnormal Bleeding Investigation: It helps determine the underlying causes of abnormal uterine bleeding, which can be indicative of conditions like uterine polyps or fibroids.
  5. Cervical Assessment: TVS assists in assessing the cervix for abnormalities or cervical incompetence during pregnancy.


Gynecological and Obstetric Applications


  1. Fibroid Identification: TVS is effective in identifying uterine fibroids, which are common benign growths in the uterine wall.
  2. Ovarian Assessment: It helps evaluate ovarian cysts, polycystic ovaries, and other ovarian conditions.
  3. Endometrial Thickness Measurement: This ultrasound method aids in measuring the thickness of the endometrial lining, useful in evaluating conditions like endometrial hyperplasia or cancer.


  1. Early Pregnancy Monitoring: TVS is crucial for early pregnancy monitoring, providing detailed images and measurements of the developing embryo and gestational sac.
  2. Multiple Gestation Identification: It helps detect multiple pregnancies, such as twins or triplets, and monitors their development.
  3. Ectopic Pregnancy Diagnosis: TVS is instrumental in diagnosing ectopic pregnancies, which occur outside the uterus and pose serious risks.


Can Transvaginal Ultrasound Detect Pregnancy?

Yes, Transvaginal Ultrasound can effectively detect pregnancy. This procedure is particularly useful in the early stages of pregnancy, providing valuable information about the developing embryo and gestational sac. TVS offers a more detailed and precise view compared to traditional abdominal ultrasound, making it a preferred choice for early pregnancy detection.


Can Transvaginal Ultrasound Detect Early Pregnancy?

Transvaginal Ultrasound is highly adept at detecting early pregnancy, often before many other methods can confirm it. It is especially useful in the following scenarios:

Limitations and Factors Affecting Detection

While TVS is an excellent tool for early pregnancy detection, there are some limitations and factors that can affect its accuracy:

  • Gestational Age: TVS is most effective after the gestational sac becomes visible, typically around 4 to 5 weeks of pregnancy. Before this stage, it may be challenging to detect the pregnancy using this method.
  • Operator Skill: The quality of the ultrasound examination depends on the operator’s expertise. A skilled sonographer or healthcare provider is essential for accurate results.
  • Obesity: In cases of obesity, it can be more challenging to obtain clear images using TVS, which might affect the accuracy of pregnancy detection.
  • Retroverted Uterus: A retroverted (tilted) uterus can make it slightly more difficult to visualize the gestational sac early in pregnancy.


Can TVS Detect a Pregnancy at 1 Week?

While Transvaginal Ultrasound is a powerful diagnostic tool, detecting a pregnancy at just one week is often not feasible. During the first week after conception, the embryo is usually too small to be seen on an ultrasound. In most cases, the earliest TVS can reliably detect a pregnancy is around 4 to 5 weeks gestation when the gestational sac becomes visible. However, it’s important to note that individual factors, including the accuracy of dating and the sensitivity of the equipment, can influence when pregnancy is detectable.


Realistic Expectations for Early Pregnancy Detection

For those hoping to confirm pregnancy, it’s essential to have realistic expectations regarding the timing of detection. Home pregnancy tests, which detect the presence of the hormone hCG in the urine, are often the first step. These tests can provide positive results as early as 10-14 days after conception, well before the gestational sac is visible on ultrasound. TVS becomes a more reliable option as pregnancy progresses and the embryo develops.


Can Transvaginal Ultrasound Detect a 6-Week Pregnancy?

Absolutely, Transvaginal Ultrasound is typically highly effective at detecting a pregnancy at 6 weeks gestation. By this stage, the embryo has developed further, and it is often possible to visualize the heartbeat, which is a significant milestone in early pregnancy. TVS can provide detailed images and measurements of the embryo’s size and development, offering valuable information to both healthcare providers and expectant parents.


How to Prepare for Transvaginal Ultrasound?

Preparing for a Transvaginal Ultrasound (TVS) is a crucial step to ensure a successful and comfortable procedure.

Dietary Restrictions for Transvaginal Ultrasound

Before a TVS, it’s essential to be mindful of your diet. While there are no strict dietary restrictions, certain considerations can improve your experience:

  • Hydration: Staying well-hydrated is generally recommended. Proper hydration helps maintain the fluid-filled environment of the pelvic area, which can enhance the quality of ultrasound images.
  • Gas-Producing Foods: It’s advisable to avoid foods that can cause excessive gas or bloating on the day of the procedure. Gas in the abdominal area can interfere with the ultrasound imaging, making it more challenging to obtain clear pictures. Common gas-producing foods include beans, carbonated beverages, and cruciferous vegetables like broccoli and cauliflower.
  • Heavy Meals: Avoid consuming a heavy meal immediately before the procedure. A full stomach can cause discomfort during the TVS examination.


Fasting in Transvaginal Ultrasound

In most cases, fasting is not required for a Transvaginal Ultrasound. Unlike some other medical procedures, you do not need to abstain from food or water for an extended period beforehand. However, you may be advised to empty your bladder before the examination to improve image quality.


Comfort Recommendations for Transvaginal Ultrasound

Ensuring your comfort during a Transvaginal Ultrasound is a priority. Here are some tips to help you feel at ease:

  • Relaxation: Prior to the procedure, try to relax as much as possible. Deep breathing exercises or meditation techniques can be helpful in reducing anxiety.
  • Communication: If you have concerns or questions, don’t hesitate to communicate with your healthcare provider or the sonographer performing the ultrasound.
  • Positioning: You will be asked to lie on your back with your feet in stirrups, similar to a pelvic exam. While this position may feel slightly uncomfortable, it’s necessary for the ultrasound probe to access the vaginal canal.


Clothing Recommendations for Transvaginal Ultrasound

Choosing the right clothing can simplify the TVS procedure:

  • Wear Comfortable Clothing: Opt for loose-fitting, comfortable clothing that is easy to remove. This will make it more convenient to change into a medical gown if required.
  • Access to Pelvic Area: You may be asked to undress from the waist down, so selecting clothing that allows for easy access to the pelvic area is advisable.


Transvaginal Ultrasound During Menstruation

A common concern among individuals scheduled for a Transvaginal Ultrasound is whether it can be performed during menstruation. The answer is generally yes. TVS can be conducted during menstruation without any significant issues. However, there are a few considerations to keep in mind:

  • Menstrual Products: If you are menstruating, it’s important to inform the healthcare provider or sonographer before the procedure. They may provide you with disposable covers or recommend using a tampon or menstrual cup to minimize any potential mess during the examination.
  • Pain and Discomfort: Some women may experience increased sensitivity or discomfort during TVS while menstruating. This can vary from person to person. It’s crucial to communicate any discomfort to the healthcare provider so they can make adjustments as needed to ensure your comfort.
  • Hygiene: Maintaining good hygiene is essential, as it always is during menstruation. Ensure you have an opportunity to freshen up before the procedure.


Addressing Transvaginal Ultrasound Concerns and Misconceptions

It’s natural to have concerns or misconceptions about any medical procedure, including Transvaginal Ultrasound. Here are some common concerns and how to address them:

  • Pain: While TVS can cause some discomfort, it is generally not painful. The ultrasound probe used is designed to be as minimally invasive as possible. Communicating your comfort level with the healthcare provider can help them make adjustments if needed.
  • Privacy and Modesty: Understand that healthcare professionals prioritize your privacy and modesty during TVS. You will be provided with a gown and a private space to undress, and only the necessary areas will be exposed during the procedure.
  • Safety: TVS is considered a safe procedure with minimal risks. The ultrasound waves used are non-ionizing, meaning they do not involve radiation. The healthcare provider will take necessary precautions to ensure your safety.


 What to Expect During Transvaginal Ultrasound?

If you are undergoing a Transvaginal Ultrasound to confirm or monitor pregnancy, here’s what you can expect during the procedure:

  • Preparation: Your healthcare provider may recommend emptying your bladder before the procedure, as this can improve image quality.
  • Positioning: You will be asked to lie on your back on an examination table, similar to a pelvic exam.
  • Probe Insertion: A lubricated and covered ultrasound probe is gently inserted into the vagina. While this may feel slightly uncomfortable, it is generally not painful.
  • Imaging: The probe emits sound waves and receives echoes, generating real-time images displayed on a monitor. The healthcare provider will manipulate the probe to obtain the necessary images.
  • Data Capture: The ultrasound machine records the images for analysis, and your healthcare provider may take measurements to assess the pregnancy’s development.
  • Procedure Conclusion: Once the necessary images and measurements have been obtained, the probe is removed, concluding the procedure.


Is a Transvaginal Ultrasound Painful?

One of the most common concerns about Transvaginal Ultrasound is the potential for pain or discomfort during the procedure. It’s important to understand that while TVS can be somewhat uncomfortable for some individuals, it is typically not painful. Here’s what you should know:

  • Sensation: During TVS, you may feel a sensation of pressure as the ultrasound probe is inserted into the vagina. This sensation is often described as mild discomfort rather than pain.
  • Lubrication: To minimize discomfort, the probe is typically coated with a lubricating gel, which also helps with smooth insertion.
  • Communication: It’s crucial to communicate with the healthcare provider or sonographer performing the procedure. If you experience significant discomfort, they can make adjustments to ensure your comfort.
  • Duration: The procedure is relatively short, usually lasting around 15 to 30 minutes, which also helps manage any discomfort.


What to Expect After the Transvaginal Ultrasound Procedure

After undergoing a Transvaginal Ultrasound, it’s natural to wonder about the next steps, including result interpretation and communication with healthcare providers.

  • Waiting Times for Results: The waiting time for TVS results can vary depending on factors like the healthcare facility’s resources and the urgency of your case. In some cases, preliminary findings may be discussed with you immediately after the procedure. However, for a comprehensive interpretation, it may take a day or more.
  • Communication with Healthcare Providers: Once the results are available, your healthcare provider will review and interpret them. They will then communicate the findings with you, either in person or through a follow-up appointment or phone call. It’s essential to discuss any questions or concerns you have during this consultation.


Interpreting Transvaginal Ultrasound Results

Interpreting TVS results involves understanding the ultrasound images, visual markers, and potential findings or abnormalities. Here’s a breakdown of key aspects:

  1. Interpretation of Images and Visual Markers: The ultrasound images generated during TVS are typically in grayscale. Key visual markers include:
    • Gestational Sac: In early pregnancy, the presence of a gestational sac is a significant marker.
    • Fetal Heartbeat: Later in pregnancy, the presence of a fetal heartbeat becomes crucial.
    • Ovarian Cysts: TVS can identify the presence and characteristics of ovarian cysts.
    • Uterine Abnormalities: The procedure helps identify uterine abnormalities such as fibroids and polyps.
    • Endometrial Thickness: Measurement of the endometrial lining can indicate certain conditions.
  2. Common Findings and Potential Abnormalities: TVS can detect various gynecological and obstetric conditions. Common findings include a healthy pregnancy, normal fetal development, and well-defined structures. However, potential abnormalities may include:
    • Ectopic Pregnancy: A pregnancy outside the uterus.
    • Miscarriage: Indications of non-viable pregnancy.
    • Ovarian Abnormalities: Such as cysts or tumors.
    • Uterine Abnormalities: Such as fibroids or polyps.
    • Endometrial Issues: Such as thickening or abnormalities.


Transvaginal Ultrasound Cost in India

The cost of a Transvaginal Ultrasound in India could range from approximately ₹ 500 to ₹ 2,000 or more. The cost of Transvaginal Ultrasound in India can vary widely depending on several factors, including the location of the healthcare facility, the city or region, and the purpose of the procedure. However, generally speaking, TVS is considered a relatively affordable diagnostic test in India when compared to similar procedures in many Western countries.

  • Public vs. Private Healthcare: The cost can differ significantly between public and private healthcare facilities. Public hospitals and government-run clinics often offer TVS at lower rates or even for free, making it accessible to a broader population.
  • City and Location: TVS costs can vary from city to city and region to region. Major metropolitan areas may have higher prices due to increased operational expenses, while rural areas may offer more competitive rates.
  • Purpose of the Procedure: The cost may also depend on the specific purpose of the TVS. For example, routine pregnancy monitoring may be less expensive than TVS for investigating complex gynecological conditions.
  • Insurance Coverage: If you have health insurance, it’s important to check whether TVS is covered under your policy. Some insurance plans in India do cover diagnostic ultrasound procedures.


Success Rate of Transvaginal Ultrasound in India

The success rate of Transvaginal Ultrasound in India is generally quite high. TVS is known for its accuracy and effectiveness in diagnosing gynecological and obstetric conditions. The success rate can vary depending on the specific purpose of the procedure and the skill and experience of the healthcare provider performing it.

 Obstetric Applications

In the context of pregnancy, TVS is highly successful in:

  • Detecting early pregnancies, often as early as four to five weeks.
  • Monitoring the development of the fetus.
  • Confirming the presence of a gestational sac and fetal heartbeat.
  • Identifying multiple pregnancies, such as twins or triplets.
  • Diagnosing ectopic pregnancies.


Gynecological Applications

For gynecological purposes, TVS is successful in:

  • Identifying and characterizing ovarian cysts.
  • Evaluating the uterine lining for conditions like fibroids and polyps.
  • Assessing the condition of the cervix.
  • Investigating the causes of pelvic pain or abnormal bleeding.

The success of TVS largely depends on the experience and expertise of the sonographer or healthcare provider conducting the procedure. In India, where the medical field is known for its skilled professionals, the success rate of TVS is generally high.


Risks of Transvaginal Ultrasound

Transvaginal Ultrasound is considered a safe procedure with minimal risks. However, it’s essential to be aware of potential concerns:

  • Discomfort: TVS can be uncomfortable for some individuals due to the insertion of the ultrasound probe into the vagina. This discomfort is usually mild and temporary.
  • Infection: While extremely rare, there is a minimal risk of infection associated with TVS. Healthcare providers take precautions to ensure that all equipment is properly sterilized or covered with protective barriers.
  • Bleeding: In rare cases, TVS may cause minor vaginal bleeding, particularly if you have a sensitive cervix. This bleeding is usually minimal and resolves quickly.

It’s important to communicate any concerns or discomfort during the procedure with your healthcare provider, as they can make adjustments to minimize any issues.


Benefits of Transvaginal Ultrasound

Transvaginal Ultrasound offers numerous benefits to patients in India and around the world:

  • Early Diagnosis: TVS can detect and diagnose gynecological and obstetric conditions at an early stage, allowing for timely treatment and intervention.
  • Accuracy: It provides highly detailed and accurate images of the pelvic organs, aiding in precise diagnosis.
  • Non-Invasive: TVS is a minimally invasive procedure that avoids the need for surgical exploration in many cases.
  • Pregnancy Monitoring: It plays a crucial role in monitoring the health and development of the fetus during pregnancy, offering reassurance to expectant parents.
  • Accessibility: TVS is widely available in both urban and rural areas of India, ensuring access to quality healthcare.
  • Affordability: As mentioned earlier, TVS is generally affordable, making it accessible to a broad spectrum of the population.


Transvaginal Ultrasound vs. Pelvic Ultrasound

Transvaginal Ultrasound (TVS): Transvaginal Ultrasound, also known as transvaginal sonography or endovaginal ultrasound, is a diagnostic imaging procedure that involves inserting a specialized ultrasound probe into the vagina. This probe emits high-frequency sound waves that bounce off internal structures, creating detailed real-time images of the female reproductive organs, including the uterus, ovaries, cervix, and fallopian tubes.

When Transvaginal Ultrasound is Used:

  • TVS is often preferred for early pregnancy monitoring, as it provides close-up views of the gestational sac and fetal development.
  • It’s instrumental in assessing gynecological conditions such as ovarian cysts, uterine fibroids, and polyps.
  • TVS plays a role in fertility evaluations, helping identify potential issues in the reproductive system.


Transvaginal Ultrasound Advantages:

  • High-resolution images due to proximity to the pelvic organs.
  • Enhanced detection capability, especially in early pregnancy.
  • Reduced need for a full bladder, which is required for traditional abdominal ultrasound.


Pelvic Ultrasound: Pelvic Ultrasound, also known as abdominal or transabdominal ultrasound, is a more common type of ultrasound that involves applying a transducer (ultrasound probe) externally on the abdominal area. The transducer emits sound waves through the abdominal wall, and these waves bounce back to create images of the pelvic organs.

When Pelvic Ultrasound is Used:

  • Pelvic ultrasound is typically used for a broader range of diagnostic purposes, including assessing the pelvic organs and structures such as the bladder, uterus, and ovaries.
  • It’s commonly employed for monitoring pregnancy after the first trimester when the fetus is larger and can be easily seen through the abdominal wall.
  • For certain gynecological and obstetric evaluations, such as checking for uterine abnormalities or investigating pelvic pain.


Pelvic Ultrasound Advantages:

  • Non-invasive, as it doesn’t require the insertion of a probe into the vagina.
  • Suitable for various abdominal and pelvic examinations.
  • Often used later in pregnancy when a more comprehensive view is needed.


Transvaginal Ultrasound Alternative Pregnancy Tests

What is the Finger Test in Pregnancy?

The “Finger Test” is a traditional, non-medical method sometimes used to assess pregnancy. However, it’s essential to note that it lacks scientific validity and is not a substitute for medical evaluation. Here’s a basic overview:

  • Procedure: In the Finger Test, a healthcare provider inserts one or two fingers into the vagina and feels for changes in the cervix and uterine position. They may look for softening, enlargement, or other alterations that can occur during pregnancy.
  • Limitations: The Finger Test is highly subjective and prone to interpretation bias. It cannot reliably confirm or determine the stage of pregnancy, and it lacks the precision and accuracy of modern medical tests like pregnancy tests or ultrasound.


Can Ultrasound See Inside the Uterus?

Yes, ultrasound can see inside the uterus, providing detailed images of the uterine cavity and its contents. This capability is particularly useful for:

  • Confirming the presence and location of a gestational sac during early pregnancy.
  • Monitoring the development of the fetus during all stages of pregnancy.
  • Diagnosing uterine abnormalities such as fibroids, polyps, or adhesions.

Ultrasound is a non-invasive imaging technique that uses sound waves to create visual representations of internal structures. During pregnancy, it offers invaluable insights into the health and progress of the pregnancy.



Transvaginal Ultrasound is a specialized diagnostic tool with a wide range of applications in gynecology and obstetrics. Its unique approach, along with its ability to provide detailed images of the female reproductive organs, makes it an invaluable tool for diagnosing and monitoring various medical conditions, especially in the realm of women’s health. Whether it’s confirming pregnancies, assessing fertility, diagnosing pelvic pain, or evaluating gynecological and obstetric conditions, TVS plays a pivotal role in improving the healthcare outcomes of women worldwide.

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    Dr Mona Dahiya

    Dr Mona Dahiya

    IVF Specialist & Consultant

    Dr Mona Dahiya has performed over 5,000+ IVF cycles and is considered a global expert in IVF, ICSI, IUI and male fertility treatment. She is an eminent writer on Infertility Treatment and has over 100 Publications in both International and National Journals. Dr Mona Dahiya has immensely contributed to the field of infertility through her Research and articles.

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