Private Pelvic Ultrasound London: PCOS, Fibroids, Fertility and Everything Your Scan Can Reveal

A pelvic ultrasound is one of the most important diagnostic tools in women's health. It is the investigation that identifies ovarian cysts, diagnoses PCOS, maps fibroids, assesses fertility, evaluates endometrial changes, and provides early pregnancy reassurance — all safely, painlessly, and without radiation.

If you are experiencing pelvic pain, irregular periods, heavy bleeding, bloating, difficulty conceiving, or you have been told you might have PCOS or fibroids, a pelvic ultrasound is almost certainly the first investigation your gynaecologist would recommend. The question is whether you wait weeks for an NHS appointment or get answers today with a private scan performed by a doctor who can explain every finding as it appears on screen.

Ready to book? Message us on WhatsApp or email team@thewellnesslondon.com.

What a Pelvic Ultrasound Examines

A comprehensive pelvic ultrasound assesses the following structures:

Uterus: Size, shape, position (anteverted or retroverted), and myometrial texture. The scan identifies fibroids (leiomyomas), adenomyosis, structural abnormalities, and uterine anomalies.

Endometrium: Thickness and morphology of the uterine lining. Endometrial thickness varies throughout the menstrual cycle, but abnormally thick or irregular endometrium can indicate polyps, hyperplasia, or other pathology. This assessment is critical in postmenopausal women experiencing bleeding.

Ovaries: Size, volume, follicle count, and presence of cysts or masses. Ovarian morphology is a key diagnostic criterion for PCOS. The scan also characterises ovarian cysts — simple cysts are typically benign, while complex cysts with solid components, septations, or irregular blood flow may require further evaluation.

Fallopian tubes: Not typically visible on ultrasound unless dilated (hydrosalpinx) or surrounded by fluid. Visible tubes on ultrasound often indicate pathology.

Adnexa: The space around the ovaries and fallopian tubes, assessed for masses, free fluid, or signs of endometriosis.

Bladder: Included in transabdominal scans, assessing bladder wall and volume.

PCOS: How Ultrasound Helps Diagnose Polycystic Ovary Syndrome

Polycystic ovary syndrome is one of the most common endocrine disorders in women of reproductive age, affecting approximately 8–13% of women globally according to the World Health Organization. Despite its name, PCOS is not simply about having cysts on the ovaries — it is a metabolic and hormonal condition with wide-ranging effects.

The 2023 international evidence-based guideline for PCOS (Teede et al., Journal of Clinical Endocrinology & Metabolism, 2023) confirmed the diagnostic criteria. PCOS is diagnosed when at least two of the following three features are present:

1. Irregular menstruation — cycles longer than 35 days, fewer than 8 cycles per year, or absent periods
2. Clinical or biochemical hyperandrogenism — acne, excess hair growth (hirsutism), hair thinning, or elevated testosterone on blood tests
3. Polycystic ovarian morphology on ultrasound — 12 or more antral follicles per ovary (using older criteria) or 20 or more per ovary using newer higher-resolution ultrasound technology, or ovarian volume exceeding 10ml

The PCOS diagnostic scan at The Wellness (£245) specifically assesses:

• Antral follicle count across both ovaries
• Ovarian volume measurement
• Ovarian morphology and stromal appearance
• Uterine assessment and endometrial thickness

Your doctor interprets these findings in the context of your symptoms and blood tests to either support or help exclude a PCOS diagnosis. If PCOS is confirmed, your doctor can discuss management options and arrange further investigations if needed.

Suspect you may have PCOS? Book a PCOS diagnostic scan on WhatsApp.

Fibroids: What Ultrasound Reveals About Uterine Fibroids

Uterine fibroids (leiomyomas) are benign growths of the uterine muscle that affect up to 70–80% of women by age 50, according to data from the British Fibroid Trust and peer-reviewed prevalence studies. Many women with fibroids are asymptomatic, but fibroids can cause heavy menstrual bleeding (menorrhagia), pelvic pressure or pain, frequent urination, difficulty conceiving, and pregnancy complications.

Pelvic ultrasound is the first-line investigation for fibroids and can determine:

• Number and size of fibroids — from small incidental findings to large fibroids measuring several centimetres
• Location — submucosal (protruding into the uterine cavity, most likely to cause heavy bleeding), intramural (within the muscle wall), or subserosal (on the outer surface)
• Impact on the cavity — whether fibroids are distorting the endometrial cavity, which is relevant for fertility and treatment planning
• Blood supply — Doppler assessment of fibroid vascularity

This information directly guides treatment decisions. Small, asymptomatic fibroids may simply be monitored. Fibroids causing significant symptoms may be managed medically or surgically, depending on their size, location, and the patient's reproductive plans.

The fibroid and uterine assessment at The Wellness costs £225 and includes a full uterine assessment with fibroid mapping, measurement, and doctor debrief.

Fertility: What Your Pelvic Ultrasound Tells You About Your Reproductive Health

If you are planning a pregnancy, considering egg freezing, or about to start IVF, a pelvic ultrasound provides essential baseline information about your reproductive anatomy and ovarian reserve.

Antral follicle count (AFC): The number of small, resting follicles visible on ultrasound in the early follicular phase (days 2–7 of your cycle). AFC is one of the most reliable ultrasound markers of ovarian reserve — the estimated number of eggs remaining. A higher AFC generally indicates greater ovarian reserve. Combined with an AMH (anti-Müllerian hormone) blood test, AFC provides a comprehensive picture of your fertility potential.

Uterine assessment: Confirming normal uterine anatomy, identifying fibroids or polyps that could affect implantation, and assessing endometrial appearance.

Ovarian assessment: Checking for cysts, endometriomas, or other pathology that may need to be addressed before fertility treatment.

The Wellness offers several fertility-focused scans:

The Fertility Scan Package at £395 is specifically designed to give you everything your fertility specialist needs before your first consultation. AMH blood tests can be added as an option.

Planning your fertility journey? Message us on WhatsApp to discuss the right scan for your stage.

Other Conditions a Pelvic Ultrasound Can Investigate

Ovarian cysts: Ultrasound characterises cysts as simple (fluid-filled, almost always benign), complex (containing septations, solid components, or irregular features), or endometriomas (chocolate cysts associated with endometriosis). Size, appearance, and Doppler blood flow patterns help your doctor determine whether a cyst needs monitoring, further investigation, or intervention.

Endometriosis: While mild endometriosis may not be visible on ultrasound, deep infiltrating endometriosis and endometriomas can be identified. Transvaginal ultrasound with dynamic assessment is increasingly recognised as a valuable non-invasive tool for detecting endometriosis without the need for laparoscopy.

Endometrial polyps: Small growths on the uterine lining that can cause irregular bleeding. Best seen on ultrasound in the early proliferative phase.

Adenomyosis: A condition where endometrial tissue grows into the uterine muscle wall, causing painful, heavy periods. Ultrasound features include an enlarged, asymmetric uterus with specific textural changes.

Postmenopausal bleeding: Any bleeding after menopause requires urgent investigation. NICE guidelines recommend pelvic ultrasound to assess endometrial thickness as the first-line investigation. An endometrial thickness below 4mm in a postmenopausal woman is reassuring.

IUD/IUS check: Ultrasound can confirm correct positioning of intrauterine devices (coils).

Transabdominal vs. Transvaginal: Which Scan Do You Need?

Transabdominal ultrasound (£225): The probe is placed on your lower abdomen. Requires a full bladder to create an acoustic window. Provides a good overview of the uterus, ovaries, and pelvic structures. Non-invasive and suitable for all patients.

Transvaginal ultrasound (TVS, £265): A slim, covered probe is gently inserted into the vagina. Provides significantly higher resolution images because the probe is closer to the structures being examined. Preferred for assessing endometrial thickness, small ovarian cysts, early pregnancy, and fertility-related measurements.

Transvaginal ultrasound is more accurate for most gynaecological assessments, but it is always your choice. If you prefer a transabdominal scan only, this is absolutely respected. Your doctor will discuss the options and recommend the most appropriate approach for your clinical question.

How to Prepare for a Pelvic Ultrasound

For a transabdominal scan: Drink approximately 500ml of water about one hour before your appointment and avoid emptying your bladder. A full bladder pushes the bowel out of the pelvis and creates a clear window for imaging.

For a transvaginal scan: An empty bladder is preferred, as this improves comfort and image quality. You will be asked to undress from the waist down and a sheet will be provided for your comfort.

Timing in your cycle: For most assessments, the scan can be performed at any point in your cycle. For antral follicle count and fertility assessments, days 2–7 are recommended. For endometrial assessment, the early proliferative phase (days 5–10) provides the clearest baseline measurement.

What Makes The Wellness Different for Pelvic Ultrasound

Pelvic scans are intimate. The environment, the sensitivity of the examiner, and the quality of communication matter as much as the technical quality of the scan. At The Wellness:

• Every scan is performed by a GMC-registered doctor who can interpret findings, answer clinical questions, and recommend next steps — all in the same appointment
• Findings are explained to you during the scan, not communicated through a separate report days later
• The clinic environment is private, comfortable, and designed for dignity
• Same-day written reports are issued within two hours
• No GP referral is needed — you can self-refer directly
• If further investigation or specialist referral is needed, your doctor arranges this the same day

Book Your Pelvic Ultrasound

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📧 Email: team@thewellnesslondon.com

🌐 Book online: thewellnesslondon.com/ultrasound

This article was reviewed by the clinical team at The Wellness London. All scans are performed by GMC-registered doctors. Last updated March 2026.

Medical disclaimer: This information is for educational purposes and does not replace professional medical advice. Always consult a qualified healthcare provider for diagnosis and treatment.