What is the primary purpose of transvaginal ultrasound in infertility assessment?

• A. To measure endometrial thickness only.
• B. To evaluate uterine and ovarian anatomy and identify fibroids or anomalies.
• C. To assess male semen parameters.
• D. To screen for infectious diseases.

Answer: (B)

Transvaginal ultrasound provides high-resolution imaging of the uterus and ovaries, making it the best way to identify structural factors that can cause infertility. It allows you to see the uterine cavity shape and contour for anomalies (like septate or bicornuate uterus), detect fibroids or polyps, and assess the endometrial lining. It also examines the ovaries for size, texture, and the presence of functional cysts or other pathology, and can give information about ovarian reserve when counting antral follicles. This structural assessment directly informs prognosis and guides subsequent testing or treatment decisions, such as whether surgical removal of lesions or a different fertility strategy is needed. While you can measure endometrial thickness and monitor follicle development with scans, those roles are adjunctive; semen analysis evaluates male factors, and screening for infections isn’t the primary purpose of this imaging study.