Trans-vaginal scan: Here's everything you want to know

This is done at a stage when the foetus is very small and cannot be seen in an abdominal scan.

For women who come to doctors in the early stages of pregnancy, like before the first month of pregnancy, one of the first things the gynaecologist will ask you to undergo is a trans-vaginal scan. Tran-Vaginal Scans (TVS) are done for diagnosis of very early pregnancy, for assessing the cervical length in the case of pre-term labour. This is done at a stage when the foetus is very small and cannot be seen in an abdominal scan.

"TVS gives a better visualisation of the pelvic structure. Moreover,TVS gives a better visualization of images of organs deep in the pelvic cavity,' said Dr Alka Kumar, Consultant Obstetrician & Gynecologist, S.L. Raheja Hospital.

It forms an integral part of the evaluation as far as fertility is concerned. But many women are not comfortable with TVS.

Many times, women feel uncomfortable when the probe is inserted in the vagina. This is especially the case for those who have a history of any trauma in that region or who have pain during intercourse (dyspareunia). Many avoid TVS as it involves exposure of private parts and hence opt for an abdominal scan. 'The TVS scan starts with a proper explanation regarding the procedure first and then we explain the need and importance to the patient. 'This initial step of counselling is very important because it helps in relieving the anxiety of the female pertaining to the procedure; so that she feels comfortable and relaxes her muscles well enough so that she co-operates till the entire scan is done,' added Dr Anagha Karkhanis, Director of Cocoon Fertility. The woman is told to lie down on her back (dorsal lithotomy position) in a comfortable way. The woman is asked to undress from the waist down and is covered with a sheet. The transducer (probe) used for TVS is slightly larger than a tampon and especially shaped to fit comfortably into the vagina,' explained Dr Karkhanis.

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After this procedure of initial explanation, the probe, covered with a disposable cover with lubricant jelly placed over it, is gently inserted into the vagina.

Why is it considered unsafe by women?

The safety needs to be explained- Though it seems an invasive procedure it is totally safe. It does not cause any injury or inflict pain if done properly. Some amount of discomfort may occur; but pain is rare unless there is some pathology. This can be further decreased by use of lubricant jelly.

'Conversing with the patient during the scan will also help in diverting her attention. It is better to change and put new probe cover in front of the patient so that she feels safer. The radiation exposure with the scan is very low and it is totally safe even in pregnancy,' said Dr Karkhanis.

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What other options are available?

Alternative for a TVS scan is abdominal scanning. The uterus and ovaries can be seen on an abdominal scan too. In thin women, the assessment is as good as with a TVS scan. In obese women, the vision may not be clear and important signs may be masked or missed. Also, a woman needs to have a full bladder for visualizing the pelvis on an abdominal scan and this may produce discomfort of having a full bladder.

TVS scan offers much more clarity and confidence for assessment and hence most IVF doctors prefer TVS to abdominal scanning.

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