An ovarian ultrasound visualizes the ovaries’ size, shape and internal structure, showing follicles, developing eggs, cysts (simple or complex), solid masses or tumors, and conditions like polycystic ovaries or endometriomas. It can detect pelvic fluid and, with Doppler, assess blood flow to ovarian tissue or masses. Results help diagnose pain, irregular periods, infertility, or guide procedures.

A normal ovarian ultrasound shows ovaries of expected size and shape with a smooth outline, small antral follicles (typically 2–12 mm) scattered peripherally, and no complex cysts, solid masses, or significant free fluid. Follicles are simple and thin-walled, with no abnormal vascularity on Doppler. No signs of torsion, infection, or malignancy are present.

An ovary ultrasound is generally not painful. A transabdominal scan may cause pressure and discomfort from a full bladder. A transvaginal ultrasound can cause mild discomfort, pressure, or brief cramping, but is usually well tolerated. If you have pelvic pain, large cysts, infection, or severe discomfort, tell the sonographer so they can stop or adjust the exam.

An ovary ultrasound can identify polycystic ovarian morphology—multiple small follicles and often an enlarged ovary—which supports a PCOS diagnosis. However, ultrasound alone cannot confirm PCOS because diagnosis also requires clinical signs (irregular periods, excess androgens) and/or blood tests. Transvaginal scans are more accurate than abdominal ones, and ovarian appearance can vary with age, contraceptive use, and other conditions.

Transvaginal or pelvic ultrasound can often show signs of ovarian infection—enlargement, complex or cystic adnexal masses, tubo‑ovarian abscess, and increased Doppler flow—but it cannot definitively diagnose early or purely inflammatory infection without structural change. Clinical assessment, inflammatory markers, and sometimes CT/MRI or surgical evaluation are needed when ultrasound is inconclusive or complications are suspected.

Follow facility instructions; for pelvic/transabdominal scans you’ll usually need a full bladder. Drink about 500–1,000 mL (16–32 oz) of plain water 45–60 minutes before the exam, sip steadily, and avoid caffeine or diuretics. Do not urinate until after imaging. For transvaginal ultrasounds you may be asked to empty your bladder instead. Arrive on time.