Yes, ovaries can be seen on an ultrasound, which is the standard, non-invasive method for imaging pelvic organs. An ultrasound uses high-frequency sound waves transmitted by a handheld transducer. These sound waves bounce off internal structures and return to the transducer, where a computer interprets them to create a real-time image. This allows healthcare providers to quickly visualize the size, shape, and structure of the ovaries, which is essential for evaluating reproductive health.
Understanding Ultrasound Modalities
Imaging the ovaries involves two distinct ultrasound methods: transabdominal and transvaginal. The transabdominal technique moves the transducer across the lower abdomen, providing a broad overview of the pelvic region. A full bladder is often necessary for this scan, as the fluid acts as an “acoustic window,” pushing the overlying bowel loops out of the way to improve sound wave transmission to deeper structures. However, the resolution of transabdominal imaging for the ovaries is lower, especially in patients with a thicker abdominal wall.
The transvaginal ultrasound offers a significantly higher level of detail and is the preferred method for assessing ovarian structure. This procedure uses a specialized, narrow transducer gently inserted into the vagina, positioning the probe much closer to the ovaries. Because of this proximity, the sound waves do not have to travel through as much tissue, resulting in sharper, higher-resolution images of the ovaries and uterus. Preparation for a transvaginal scan usually requires the bladder to be empty, which optimizes the clarity of the pelvic structures.
What Affects Ovarian Visibility
Several physiological factors can make locating or clearly visualizing the ovaries challenging. Excessive gas or fecal matter within the nearby bowel loops can scatter sound waves, creating acoustic shadows that obscure the ovarian field. A high body mass index (BMI) also increases the distance from the external probe to the ovaries, causing sound waves to attenuate, or weaken, before they return to the transducer. This is why the transvaginal approach is often favored for a detailed ovarian assessment.
Previous pelvic surgeries, such as a Cesarean section or appendectomy, can lead to scar tissue formation that alters the normal anatomical position of the ovaries, making them harder to find. Hormonal status also plays a considerable role in visibility, particularly after menopause. Following the cessation of menstruation, the ovaries naturally decrease in size, often shrinking to a volume that makes them difficult to differentiate from surrounding tissue.
Clinical Purposes of Ovarian Imaging
Ovarian ultrasound is a primary diagnostic tool used to investigate a wide range of gynecological concerns, including unexplained pelvic pain, abnormal uterine bleeding, and fertility issues. It provides a clear visual assessment of the pelvic organs that may be contributing to discomfort. The scan is also used to identify and characterize ovarian masses, which is a major clinical utility of the procedure.
The ultrasound appearance helps distinguish between common, benign simple cysts and complex masses. Simple cysts appear as thin-walled, anechoic (black, fluid-filled) sacs that are often functional and resolve on their own, requiring only monitoring. In contrast, complex masses may contain internal walls called septations, solid components, or papillary projections, which raise suspicion and require further investigation. Specialized techniques like Doppler ultrasound assess blood flow patterns within any solid areas, as increased vascularity can indicate a malignant process.
For fertility treatments, transvaginal ultrasound is routinely used for follicular tracking, monitoring the growth of the fluid-filled sacs that contain eggs. The sonographer measures follicle size, aiming for a mature diameter, typically between 18 and 25 millimeters, to accurately time ovulation or egg retrieval. Ultrasound also evaluates conditions like Polycystic Ovary Syndrome (PCOS), where the ovaries may be enlarged and display a characteristic “string of pearls” pattern. This appearance is created by 12 or more small follicles, usually 2 to 9 millimeters in size, lining up just beneath the ovarian surface.