Gynaecology / Fertility Ultrasounds

A pelvic ultrasound is a medical imaging test used to examine the uterus, ovaries, cervix, and surrounding pelvic structures. There are two main types of pelvic ultrasounds:

• Transvaginal ultrasound (internal)
• Transabdominal ultrasound (external)

Where appropriate, the internal (transvaginal) approach is preferred as it provides clearer and more detailed images of the pelvic organs.

What is an internal (transvaginal) ultrasound?

A transvaginal ultrasound involves inserting a narrow ultrasound probe, specifically designed for this purpose, into the vagina. The probe is covered with a sterile cover and lubricated. This close positioning allows for highly detailed images of the pelvic organs.

During the scan, the sonographer or doctor may apply gentle pressure to your lower abdomen to enhance visibility. You are in full control during the examination. If at any point you feel discomfort or wish to stop, the procedure can be paused or ended.

Please note: If you are comfortable having the pelvic examination performed internally, a completely empty bladder is required for this type of scan.

What is an external (transabdominal) ultrasound?

A transabdominal ultrasound uses a specific gel and probe on the lower abdomen to view the pelvic organs. While this method provides less detail than the internal scan, it is the appropriate choice the following individuals:

• Younger or underage patients
• Individuals who have not been sexually active
• Patients who do not consent to an internal scan

Please note: If you opt to have an abdominal scan, a full bladder is required. Please arrive well-hydrated and your bladder very full in preparation for this scan.

Why is a pelvic ultrasound performed?

A pelvic ultrasound may be requested for many reasons, including:

• General pelvic check-up
• Family history of gynaecological cancer
• Abnormal bleeding
• Pelvic pain
• Fertility assessment

It can also help monitor or diagnose conditions such as:

• Fibroids
• Polyps
• Ovarian cysts
• Endometriosis / Adenomyosis
• Hydrosalpinx (fluid-filled fallopian tubes)

Who performs the scan?

Pelvic ultrasounds are performed by one of our skilled sonographers. On occasion, our male sonologist doctor (specialist in obstetrics and gynaecological ultrasound) may also conduct or assist with the scan.

When is the best time to schedule a pelvic ultrasound?

While a pelvic ultrasound can be performed at any time, the clearest images are usually obtained just after your period and before ovulation—typically between days 7 and 12 of a 28-day cycle.

Pelvic ultrasounds are safe during pregnancy and can still be performed if there is spotting or bleeding, if necessary.

How long do the results take?

After your scan, our specialist doctor (sonologist) will review the images and prepare a detailed report, which is sent directly to your doctor generally within 24 hours.

A Deep Infiltrating Endometriosis Scan (commonly known as a DIE scan) is a specialised pelvic ultrasound used to assess for signs of deep endometriosis. This detailed scan provides critical information for diagnosing and planning treatment or surgery for endometriosis.

What is endometriosis?

Endometriosis is a common condition affecting approximately 1 in 10 menstruating women. It occurs when tissue similar to the lining of the uterus (the endometrium) grows outside the uterus in other areas of the pelvis, including:

• The ovaries
• The uterine muscle (adenomyosis)
• The bowel, bladder, or other pelvic structures

This abnormal tissue responds to hormonal changes during the menstrual cycle, which can cause inflammation, pain, and scarring (fibrosis).

Common symptoms of endometriosis

• Severe period pain that interferes with daily activities (work, school, exercise, etc).
• Pain during or after intercourse.
• Persistent period pain despite use of the oral contraceptive pill (OCP).
• Ovarian cysts.
• Bowel or urinary symptoms associated with menstruation.
• Heavy bleeding, bleeding between periods, or bleeding after sex.
• Difficulty conceiving (infertility).

 The two types of endometriosis

• Superficial Endometriosis: Affects the surface of pelvic organs.
• Deep Infiltrating Endometriosis (DIE): More extensive form involving the bowel, bladder, or deeper pelvic tissues.

Who should have a DIE scan?

A DIE scan may be recommended for:

• Individuals with moderate to severe endometriosis symptoms
• Anyone planning surgery for suspected endometriosis
• Those with a history of endometriosis and worsening symptoms

The scan helps guide clinical decisions and surgical planning by identifying the extent and location of endometriotic lesions.

What to expect during a DIE scan

The scan is performed as a transvaginal ultrasound by a qualified sonographer or specialist doctor. We allocate a 30-minute appointment time, which may take slightly less or more depending on findings and the extensiveness.

Preparation for the scan

To ensure clear imaging, bowel preparation is required:

• The night before the scan: Take a mild laxative
• 1–2 hours before the scan: Use a rectal enema or suppository.

This preparation helps improve the visibility of the space between the uterus and bowel, which is essential for surgical planning. An information sheet will be provided upon booking. The bowel prep medications are available over-the-counter and cost around $20.

Treatment for endometriosis

Endometriosis is a complex condition that requires individualised care. Your treatment plan should be discussed in detail with your referring doctor or gynaecologist.