Imaging in Fertility
Investigation & Treatment

To help with a fertility problem, we usually need imaging tools to assess the situation and pinpoint the cause. Here's a rundown of the main methods in use.

דף הבית / Imaging in Fertility Investigation & Treatment

Ultrasound (sonar)

A medical imaging technique that uses high-frequency sound waves to create pictures of internal organs. In fertility care, a standard ultrasound is an important diagnostic tool for examining the state of the ovaries, uterus, and fallopian tubes. It lets us:

Diagnose structural problems — spotting structural anomalies in the uterus such as septa, polyps, fibroids, or adhesions that can affect fertility.
Assess the ovaries — checking their condition, counting and sizing the follicles, and helping diagnose conditions like polycystic ovaries or reduced fertility.
Track follicle development — following the follicles through hormonal treatment cycles, to pin down the right moment for the ovulation-trigger injection (hCG) and for egg retrieval, or for timing intercourse/insemination.
Assess the uterine lining — measuring the thickness of the endometrium (a key factor in whether an embryo implants successfully) and checking for irregularities or adhesions.
Diagnose early pregnancy — confirming a pregnancy early on, including the gestational sac, fetal heartbeat, and where implantation occurred, to rule out an ectopic pregnancy.

Advantages: available, safe, radiation-free, and relatively accurate.

Hydrosonography

Also known as sonohysterography, this pairs ultrasound with fluid injected into the uterine cavity, to create a clearer, more precise picture of the cavity. It lets doctors examine the shape of the uterus and identify problems that could affect fertility.

Used in fertility care to:

Diagnose polyps and fibroids — the injected fluid expands the cavity, making them easier to see clearly.
Identify adhesions — spotting intrauterine adhesions (synechiae) that affect fertility.

Advantages: safe and accurate.

EXEM-FOAM

EXEM-FOAM is an innovative technique for imaging and examining the uterine cavity and fallopian tubes, combining a special foam with ultrasound. The procedure is also known as HyCoSy (Hysterosalpingo-Contrast-Sonography).

How the exam works:

Getting ready — you lie on the exam bed, much as you would for a routine gynecological exam.
Inserting a catheter — a thin catheter is passed through the cervix into the uterine cavity.
Injecting the foam — EXEM-FOAM, a contrast agent made of a saline solution plus a special bubble-forming substance, is injected through the catheter into the cavity and the tubes.
Performing the ultrasound — once the foam is in, a standard (usually vaginal) ultrasound is carried out to capture images of the cavity and tubes.

Used in fertility care to show whether the fallopian tubes are open, and to view the uterine cavity.

Advantages of EXEM-FOAM

Precision and image quality — the foam gives a clear view of the cavity and tubes, sharpening the ultrasound picture.
Safety — considered safe, with no X-rays or ionizing radiation.
Less pain — a less painful procedure than alternatives such as an HSG (uterine X-ray).
Simpler preparation — no special prep beforehand, and it’s considered relatively comfortable.

Hysterosalpingography (HSG) — uterine X-ray

An X-ray exam in which contrast is injected into the uterine cavity and tubes to check their structure. It can detect blocked tubes, congenital anomalies, polyps, internal adhesions, and an abnormal uterine shape. If a blockage is seen, sometimes the pressure of the fluid can open it.

Hysteroscopy

A minimally invasive procedure in which a tiny camera (a hysteroscope) is passed through the cervix into the uterus. It’s used to diagnose and treat a range of issues — polyps, fibroids, adhesions, congenital anomalies — and sometimes to check the cavity before fertility treatment. It’s both a diagnostic and a treatment tool. It can be done with or without anesthetic, depending on the purpose and the woman’s pain threshold.

ניתן לעשות את הפעולה אם או בלי הרדמה, תלוי במטרת הפעולה וסף הכאב של האישה.

Used in fertility care to:

Diagnose structural problems — identifying congenital anomalies, septa, polyps, fibroids, and adhesions inside the uterus.
Treat polyps and fibroids — removing polyps, fibroids, and adhesions precisely.
Check the uterine lining — assessing the thickness and quality of the endometrium, which matters for embryo implantation.
Diagnose and grade adhesions — finding and removing intrauterine adhesions that can affect fertility.

Advantages: high precision, treatment during the same exam, quick recovery, and relatively less invasive than surgery.

3D Ultrasound

An advanced imaging method that uses ultrasound to create three-dimensional images of the uterus and ovaries, allowing a more precise assessment of the shape of the uterus, with an emphasis on detecting structural anomalies.

Advantages: non-invasive and accurate.