This presentation provides an overview of targeted ultrasound assessment in in vitro fertilization (IVF) and assisted reproductive technology (ART), emphasizing ultrasound as a purpose-driven clinical tool rather than a screening examination. Each scan is performed to answer specific clinical questions that directly guide patient management. The rationale for serial ultrasound examinations is outlined, including baseline, monitoring, and pre-trigger or pre-transfer scans, highlighting the importance of trend analysis over single measurements. Key parameters assessed include follicular number, size, growth rate, and symmetry, as well as endometrial thickness, morphology, and cyclical pattern changes. The complementary role of hormonal blood tests— ie: estradiol, luteinising hormone, and progesterone—is discussed in optimizing medication dosing, cycle progression, and timing of ovulation trigger, egg collection, and embryo transfer. Differences between stimulated fresh IVF cycles and frozen embryo transfer cycles are examined. The presentation also reviews medication effects on imaging appearances, the adjunctive role of transabdominal scanning, and key take-home messages supporting accurate interpretation and safe multidisciplinary practice.

This lecture will provide an introductory overview of pelvic floor ultrasound, including foundational anatomy and the relevant pelvic compartments. The session will cover standard examination protocols, equipment requirements, and techniques used to assess and quantify prolapse, with reference to key measurement values. Emphasis will be placed on correlating clinical symptoms with imaging findings, and how to tailor the assessment based on patient history and presenting concerns. Practical insights and personal tips gained from several years of hands-on experience will also be shared.

Takeaways:
Understand the growing demand for pelvic floor ultrasound and its critical role in the diagnosis and management of pelvic floor disorders.
Gain confidence in performing pelvic floor ultrasound by learning structured protocols and recognising key anatomical landmarks.
Appreciate the importance of a thorough patient history in guiding the assessment and identifying pathology.

Introduction; Hysterosalpingo-foam sonography (HyFoSy) is increasingly established as a first-line investigation for assessing tubal patency in infertility work-up due to its favourable safety profile, patient acceptability, and diagnostic effectiveness. While often viewed as a clinician-led test, HyFoSy is inherently operator-dependent. Sonographers play a critical role in examination success through thorough preliminary pelvic assessment, optimisation of real-time imaging, patient reassurance, and contribution to diagnostic accuracy.
Methods: This presentation includes a retrospective audit of 50 consecutive sonographer-performed HyFoSy examinations conducted over a 3–6-month period. Outcomes were categorised as bilateral patency, unilateral patency, or absent contrast flow. Factors influencing these results were reviewed to determine whether findings reflected technical limitations, patient discomfort, tubal spasm, or true tubal occlusion. This allowed evaluation of the impact of sonographer technique and real-time clinical decision-making.
Results: Audit findings will be discussed during the presentation to demonstrate how sonographer performance and real-time interpretation influence diagnostic outcomes. In light of the audit results, practical aspects of HyFoSy will be explored, including optimisation of ultrasound machine settings, recognition of normal and abnormal contrast flow patterns, differentiation between tubal spasm and true occlusion, and strategies for managing challenging anatomy.
Conclusion: HyFoSy is a highly operator-dependent examination in which sonographers play a central role in producing accurate, clinically meaningful assessments. Integrating audit data with practical guidance supports reflective practice, service development, and standardisation of sonographer-led HyFoSy services.
Take-Home Message: Successful HyFoSy extends beyond contrast administration—sonographer expertise and patient-centred care are fundamental to reliable tubal patency assessment.