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Ultrasound evaluation of the normal menstrual cycle

Judith M Adams, DMU
Section Editors
Robert L Barbieri, MD
William F Crowley, Jr, MD
Deputy Editor
Kathryn A Martin, MD


Transvaginal ultrasonography provides a direct and sensitive method of monitoring ovarian size and follicular development during the menstrual cycle and is superior to transabdominal ultrasonography in several ways. When a high-frequency transducer is placed in the vaginal fornix close to the organs of interest, image quality is greatly improved, particularly in obese women. There is no requirement for a full urinary bladder, so patient discomfort is minimized. As a result, transabdominal ultrasonography is now reserved for situations that require a complete pelvic survey or for examining children or women who have not yet been sexually active.

This topic will review the ultrasonographic findings during the normal menstrual cycle. The events that occur during the cycle are discussed in detail separately. (See "Physiology of the normal menstrual cycle".)


The ovaries can be seen by ultrasonography throughout the menstrual cycle in normal women. Ovarian volume is determined using a simplified formula for a prolate ellipse [1].

Ovarian volume is typically used to describe ovarian size. It is calculated by multiplying the longest dimension of the ovary (in cm) by the two orthogonal dimensions by a factor of 0.523:

 Ovarian volume  =  Length (in cm)  x  width  x  thickness  x  0.523

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Literature review current through: Nov 2017. | This topic last updated: Apr 21, 2017.
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