Experienced operators are able to detect almost all ectopic pregnancies measuring more than a few millimetres in size on ultrasound scan. It is important to emphasize; however, that ectopic pregnancies tend to develop more slowly than intrauterine pregnancies and it often takes them longer to grow to the size which makes them visible on the scan. Most women with a positive pregnancy test in whom ultrasound cannot identify a pregnancy have either normal pregnancies which are younger than expected from the date of their last period or they have already suffered a miscarriage. A small proportion of these women; however, may develop small ectopic pregnancies. A blood test is usually arranged in these cases to measure the levels of pregnancy hormones in women’s blood. Based on the result of the blood test we can advise women on the likely outcome of their pregnancy and on the need for further follow up.

The earliest ultrasound can confirm the presence of a heartbeat is two weeks after a missed menstrual period or four weeks after conception. In women who conceive after IVF the heartbeat can be seen four weeks after the day of oocyte collection. Again, in order to avoid coming for the scan too early it is best to delay the attendance until two and a half to three weeks after the missed period or four and a half to five weeks after conception/oocyte collection.

A normal intrauterine pregnancy can be first seen on the scan three days after a missed menstrual period. In women who fall pregnant after fertility treatment such as ovarian stimulation the pregnancy can be seen 17 days after ovulation. In women who conceive after IVF the pregnancy can be seen 17 days after the day of oocyte collection. There are, however, small variations in the timing of conception and women who wish to confirm that their pregnancy is located within the uterus are advised to delay their attendance until a week after the missed period (or three weeks after conception) to avoid coming for the scan too early. This is particularly important in women with uterine abnormalities such as fibroids or adenomyosis, which make it harder to see the pregnancy and sometimes the diagnosis may be delayed for several days.

There is no evidence that ultrasound scans can harm pregnancies. It is important to ensure, however, that the energy of ultrasound beam is kept low. Use of pulsed Doppler devices to measure blood flow should be avoided in the first weeks of pregnancy as their energy output is higher compared to the ultrasound beam used for standard imaging. Our equipment is fully compliant with the international standards for safe use in pregnancy and the machine energy output is continuously monitored during the examination.

Ovarian cancer can be accurately diagnosed on ultrasound scan. The best and most accurate way to diagnose ovarian cancer is by an expert performing a systematic and detailed examination of the tumour and the adjacent structures in the pelvis and abdominal cavity. The advantage of this approach is that it provides the information about the nature of the tumour instantly in the vast majority of cases, without the need of additional blood tests such as CA125 or MRI.

Normal Fallopian tubes are very thin and they cannot be routinely seen on the scan. If the tubes are damaged, they tend to fill with fluid which makes it possible to see them. Tubal patency can be tested using a procedure called HyCoSy which is described in the section on the services we offer to women with concerns about their fertility.