Ovarian Reserve Testing Archives - Best IVF Specialist in Gurgaon | Dr Pankaj Talwar | Male Infertility Expert
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Understanding Normal Ovaries on Ultrasound

Dr. Prof (Col) Pankaj Talwar, VSM, MD, PhD

Medical Council Registration Number: HMC-HN 16822

A baseline ultrasound of the ovaries is a critical step in assessing a woman’s reproductive health. It helps us evaluate the ovarian reserve, track the menstrual cycle, and screen for abnormalities. Here is what we look for in a normal, healthy ovary during a scan.

1. Anatomy and Volume

The ovaries are oval-shaped structures located on either side of the uterus within the ovarian fossa.

  • Mean Volume: Approximately 4.9 ml is considered normal.
  • Position: They usually lie near the internal iliac artery and vein, though their position can vary.

2. Antral Follicle Count (AFC)

The best time to evaluate the ovaries is on Day 2 or Day 3 of the menstrual cycle (Follicular Phase). During this time, we measure Antral follicles (small sacs containing immature eggs) ranging from 2-9 mm.

What the Numbers Mean:

  • Normal AFC: 5 to 10 follicles in each ovary.
  • Decreased Ovarian Reserve: A total AFC of less than 4 combined in both ovaries.
  • Polycystic Ovaries (PCO): An AFC of 12 or more in either ovary.

3. Ovulation and Color Doppler

In a natural cycle, one follicle becomes “dominant,” reaching a size of 17–24 mm before releasing the egg (ovum).

  • Blood Flow: Normal stromal blood flow velocity is 6–12 cm/sec. Flow velocity typically increases just before and immediately after ovulation.
  • Corpus Luteum: After the egg is released, the follicle transforms into the Corpus Luteum. On ultrasound, it appears as a round cystic mass with thick, echogenic walls.
  • The “Ring of Fire”: On Power Doppler, the Corpus Luteum displays a characteristic “Ring of Fire” appearance due to highly increased blood flow around it.

Is Your Ovarian Reserve Healthy?

A precise baseline scan can reveal vital information about your fertility journey. Get an expert assessment today.

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Patient Education Series

Ultrasound Basics: Why It Is The Key To Your Fertility Journey

Expert Insights by By Dr. Prof (Col) Pankaj Talwar, VSM, Md, Phd, Medical Council Registration Number – HMC-HN 16822 | Updated: April 25, 2026

In the world of fertility, an ultrasound is much more than just a picture; it is a vital diagnostic window. It helps us understand your reproductive health and tailor a treatment plan specifically for you.

Why Is Ultrasound Done?

We use high-resolution imaging to identify anything that might be coming in the way of a successful pregnancy:

  • Uterus Check: Assessing size, position (Anteverted/Retroverted), and thickness of the endometrial lining.
  • Ovary Check: Looking for volume and the number of follicles.
  • Pelvic Health: Detecting infections, fluid, or pelvic tuberculosis.
  • Detecting Abnormalities: Ruling out diseases in the tubes, ovaries, or pelvis.

How Is It Done? TAS vs. TVS

Depending on your comfort and medical requirement, we use two methods:

Transabdominal Scan (TAS)

This is done with a full bladder over the abdomen. It is usually preferred for patients with vaginismus or when observing very large pelvic masses.

Transvaginal Scan (TVS)

Done with an empty bladder by inserting a small probe gently into the vagina. This is the Gold Standard for fertility as it gives a crystal-clear view of the follicles and lining.

Timing: When Should You Have A Scan?

In fertility treatments, the timing of the scan is crucial. We usually monitor on three specific days of your cycle:

  • Day 2 (D2): To check Antral Follicular Count (AFC). A normal count is 5-10 follicles in each ovary. This helps us predict how your body will respond to treatment and rules out old cysts.
  • Day 9 (D9): To look for the Endometrial Lining. We look for a “triple-layer” pattern and use color Doppler to ensure healthy blood flow for embryo receptivity.
  • Day 21 (D21): To confirm secretory changes in the lining, ensuring the environment is ready for a pregnancy.

Expert Care with Dr. Pankaj Talwar

Accurate monitoring is half the battle won. Consult with a pioneer in ART and Clinical Embryology.

📍 3118, 3rd floor, Sector 46, Near Ambedkar Chowk, Gurugram