In-vitro fertilisation (IVF) is a complex and highly individual process, and regular monitoring is essential to ensure the best possible chances of success.
One of the key ways to track progress throughout an IVF cycle – including before and during the process – is through ultrasound scans.
IVF scans are used to assess various aspects of a woman’s reproductive health, from the condition of her ovaries and uterus before treatment, to monitoring the development of follicles during stimulation, and confirming early pregnancy.
Each IVF ultrasound scan serves a specific purpose and is designed to provide the fertility team with the crucial information they need to tailor treatment.
The scans not only help fertility specialists make informed treatment-related decisions, but also provide reassurance for the patients throughout the process. From the IVF baseline scan before any treatment starts, to early pregnancy scans after embryo transfer, each ultrasound is a step towards ensuring the treatment plan stays on track.
In this article, with expert input from one of our highly experienced sonographers, Claire Collier, we will guide you through the different IVF scans you can expect before and during your IVF cycle, when they typically occur, and what you can expect during each one.
What are the different types of IVF ultrasound scans?
Throughout the IVF journey, different scans are carried out at specific stages to monitor and support treatment. Each scan has a unique purpose, from evaluating your reproductive organs before treatment begins to confirming early pregnancy after embryo transfer.
The following are the IVF scans you can expect before and during your treatment.
Baseline Scan (IVF Pre-Treatment Scan)
The IVF baseline ultrasound scan is typically the first scan you will have before starting any treatment. Its purpose is to assess the health of your reproductive organs, and ensure there are no underlying conditions that could affect your IVF treatment.
During this scan, your fertility sonographer will examine your uterus (womb), ovaries, and surrounding areas. They will check for any abnormalities, such as fibroids or cysts, which could potentially interfere with the implantation process or, at a later stage, lead to miscarriage or stillbirth.
The shape and size of the uterus are also assessed to identify any congenital abnormalities, such as a bicornuate (heart-shaped) uterus, that may impact fertility. Any distortion of the uterus or any small lesions within the ovaries may indicate endometriosis, which is also associated with infertility.
One of the key things assessed during the IVF baseline scan is the thickness of the endometrium (the lining of the womb), which plays a crucial role in embryo implantation. This is assessed according to the menstrual cycle stage to check its normality.
The womb lining can fail to thicken for various reasons, such as scarring (as in the case of Asherman’s Syndrome where the extra tissue reduces the space in the uterus), or for hormonal reasons. It may also be thicker than it should be due to an endometrial polyp (a lesion similar to a skin tag). This can lead to implantation failure, so it is important to detect early on.
During the IVF baseline ultrasound, the sonographer will also measure your ovaries, and assess them for Polycystic Ovary Syndrome (PCOS). This condition can make it difficult to work out ovulation timing, and may interfere with egg retrieval.
The ovary location is also checked to ensure the eggs can be safely retrieved when the time comes.
In addition, a count will be made of the antral follicles, which is where the eggs are housed. This knowledge helps the clinician make the right decisions around your treatment dosages.
The IVF baseline scan is typically done in the first few days of your menstrual cycle, providing a clear picture of your natural cycle before any hormonal treatments begin. This scan ensures that any potential issues are identified early on, so your treatment can be tailored accordingly.
Follicle-tracking IVF scans (In-Treatment Scans)
During the stimulation of follicle production phase of your IVF treatment cycle, follicle tracking scans become an essential part of your monitoring process. These in-treatment IVF scans help track the development of follicles, which contain the eggs that will be retrieved for fertilisation.
During this stage, you will have hormone injections to stimulate your ovaries to produce multiple eggs.
Follicle tracking scans are vaginal IVF ultrasounds, and are typically performed every few days to monitor how the follicles are growing, and whether they are reaching the optimal size for egg retrieval. The sonographer will measure the size of each follicle to assess whether it’s growing at the expected rate.
The ultimate goal is to collect mature eggs from the follicles, so it’s crucial to monitor their development carefully. If the follicles are growing too slowly or too quickly, adjustments can be made to your medication dosage to ensure the best possible outcome.
The follicle tracking IVF scan also helps determine the ideal timing for egg retrieval, ensuring that the eggs are collected when they are mature enough for fertilisation.
The vaginal IVF ultrasound provides the clearest possible image of the ovaries and follicles. The number of scans you’ll need will depend on your individual response to stimulation, but typically, you will have a follicle tracking IVF scan every two days during the stimulation phase.
Early pregnancy scan (Six-Week Ultrasound after IVF)
The six-week ultrasound after IVF is used to assess early pregnancies. Although it is known as the ‘6-week ultrasound’, we often carry this one out at approximately seven weeks or slightly later.
The scan is performed via vaginal ultrasound, as this provides the clearest images during the early stages of pregnancy. You may be asked to have a full bladder before the scan to help improve visibility.
The sonographer will look for the presence of a gestational sac within the uterus. This is the first sign of a pregnancy, and indicates that the embryo has successfully implanted.
The main purpose of this particular IVF ultrasound is to make sure that the baby is correctly positioned within the uterus, to check it has a heartbeat and that it’s within a healthy range, and to ascertain that it’s developing as it should be.
As we know the specific date of conception, we can measure the baby to ensure it’s developing at the expected rate.
We’ll also assess the size and appearance of both ovaries following egg collection to make sure they are healing well following the retrieval process, and to monitor for any cysts or complications.
This IVF scan confirms whether the pregnancy is viable, and helps rule out issues such as ectopic pregnancy, where the embryo implants outside the uterus. It also provides a snapshot of how the pregnancy is progressing in the early stages. If there are any concerns, you will be guided through the next steps.
Following the six-week ultrasound after IVF, and depending on the findings, the clinician may schedule follow-up scans within another week or so to further monitor the pregnancy, and ensure it continues to progress as expected.
Are you seeking fertility treatment advice?
Hull & East Riding Fertility has helped create thousands of babies since it was founded in 1986. Offering a variety of services for those looking for fertility assistance, we are East Yorkshire’s only registered clinic providing specialist infertility investigations and personalised treatment, for both self-funded and NHS patients.
We also offer a range of investigatory and fertility treatment planning services at our satellite fertility clinics in York.
For self-funding patients, a GP referral is not necessary. However, all patients are entitled as standard to basic NHS funded fertility investigations, so you may wish to start there.
Whatever stage you are at in your fertility journey, Hull & East Riding Fertility is here to guide you through every stage. Please get in touch to let us know how we can help you.