Posted on March 13th, 2017 by wombwithaviewblog.com

Fetal Sex Determination

Deciphering fetal sex can be a very difficult job, especially when trying to read an image taken by someone else.  Sometimes, it’s a piece of cake!

So often, when readers send me their images for a second opinion on fetal sex, I just cannot provide a confirmatory guess. This is either due to too early gestational age, too poor an angle, or too poor an image. Sometimes, it is a combo of all three!

Ultrasound is such a different animal because it is nothing like a photograph. In a photo, you can see what’s in the distance or up close to the camera. With ultrasound, we cannot. We can only see exactly what is directly under the probe. It is a 2D (two-dimensional) image only, and we have to move the probe around to obtain different angles to create that “photograph” in our minds. And there are so many variables that go into creating a good ultrasound image.

Since ultrasound is completely subjective and observer-dependent, some sonographers take great images and some…well…don’t. It’s much like comparing a professional photograph to an out-of-focus, too dark, cell phone group portrait where everyone has red or white eyes. You know, the ones you always see posted on social media?

I am too much of a perfectionist. This wasn’t always a good thing when trying to take keepsake photos for patients because it caused me to run late on more than one occasion! And everyone knows people don’t like to wait in a medical office! Factors to take into consideration are maternal and fetal position, angle, magnification, depth, as well as brightness and contrast of the image. It’s a learned skill and some are simply better at it than others. Some just don’t tweak all the knobs as much as they should. Maybe they were never really taught how to do so very well.

A Poor Image Can Limit a Fetal Sex Guess

Some factors that cause a poor image are just beyond a sonographer’s control…like an uncooperative fetus, extra weight around a patient’s abdomen, or a gassy patient. The laws of ultrasound physics dictate that the further sound waves have to travel, the poorer the image. Also, sound does not travel well through air or gas. I’ve scanned heavier patients where I could see pretty well and thinner, gassy patients where I struggled to see at all!

That said, I can tell when someone else’s image is not great or when she didn’t work with all the knobs. This can make reading an image snapped by someone else extraordinarily difficult. One image represents only one angle. Scanning real-time allows me to look from all angles possible, where I can subjectively determine my confidence in fetal sex – or whether a guess is too risky at all.

ALL that said, sometimes taking a second guess is easy-peasy! Check out the email I received from a reader about whether her baby is a male. Her images didn’t leave much of a question in my mind:) She was just over 20 Weeks along. Can you tell what she’s having?

mama: Hello, I’ve been following your blog, and I was wondering if you could take a look at my baby’s scans and give me your opinion on gender. We were told it’s a boy, but I’ve read that girls can have parts that look similar to boys? I agree that it looks like a boy, but wanted a second opinion. Thanks!

male fetal sex

male fetal sex

wwavblogger: LOL No ma’am! Little girls don’t normally look like that at 20 Weeks! I will wager my bet on a baby boy:) Congrats!

mama: Lol! I wasn’t quite sure but I’ve had a feeling it’s a boy from the beginning of the pregnancy!

Reader mom: I forgot to mention in my reply to you that, yes, girls and boys can indeed look similar, but that is truer between the 12-16 Week range when parts are small, just developing, and when combined with other factors that come into play which result in limited visualization!

Did you guess boy? If so, I agree! Compare the images I’ve edited below.

fetal sex, male gender, ultrasound, second trimester, 2nd trimester

 

fetal sex

Even though it would be quite unusual for this to be a baby girl, I’m still always a bit cautious about guessing fetal sex based on someone else’s image. When I’m casting a vote for Team Blue, I like to ensure I see a scrotal sac which requires a slightly lower angle. Sometimes, you can obtain both scrotal sac and penis in the same image, sometimes not. I get a slight impression of a scrotal sac here where I placed the circle. The sac at this age can appear quite small, and testicles are not expected to descend until about 26-28 Weeks. This is why scanning real-time helps; it allows me to see Baby at all angles possible while moving and stretching and opening his legs more.

Stay tuned! My next post will be one where a questionable and poorly technical image comes into play. Mom wrote back saying she delivered the opposite sex. Oops!

Email me at wombviewerblog@gmail.com!

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Posted on May 12th, 2016 by wombwithaviewblog.com

Anatomy Screen Ultrasound Exam: The Breech Fetus

What’s the worst position a fetus can be in if you want to determine fetal sex? You guessed it! Look no further than the image below to answer this question. The breech fetus compromises most of what both you and I want to see.

What You Don’t Want to See

breech fetus

This image is really an example of just how much position plays a part in how well we see. This baby (above) is not only lying in a breech position, or butt-down, but baby is also facing Mom’s back (prone).

The wait for your 20 Week ultrasound exam and whether you’ll be shopping for pink or blue may have you losing sleep! The LAST thing you’ll want to see is your baby looking like the image above. It spells one word…disappointment. If baby stays in this position throughout the examination, the possibility of seeing anything cute is essentially nada.

20wk facial profile

 

Above is an example of baby flipped over and looking up. How much better do you see baby’s face?

Here’s hoping you have more luck than this patient did for her anatomy screen ultrasound exam!

Email me with your questions and comments at wombviewerblog@gmail.com!

Subscribe to my blog for reliable ultrasound information including more the breech fetus, fetal sex determination, and more.

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Posted on December 30th, 2015 by wombwithaviewblog.com

One hormonal mama (self-proclaimed) wrote me to ask about The Nub Theory. If you want to know all about it, too, read on!

Mom’s Email Regarding The Nub Theory

hormonal mama:  Hello!! 🙂 I just wanted to let you know that your blog has been a complete saviour to me and my sanity over the past few nights. It is brilliant and informative and just what I needed in my hormonal state.

I have one question that I have been searching the web for a definitive answer to, and I was hoping you could shed some much needed light.

We had our 12 Week NT scan, and the US machine seemed to be a LOT better than the photos I have seen posted, videos I have watched, etc. We could see extraordinary detail of the baby. The sonographer was checking all the usual parts and suddenly without warning he showed us the perfect potty shot (I was 12w1d). Now I know from reading that people say they all look the same at this stage. But what I cannot get over was how much the image showed a perfect little penis poking out the top of a round bulbous structure.

I’ve googled and you-tubed 12 Week girl vs boy potty shots, and I just cannot get a girl scan that looks like an actual penis.

I’m clinging to the smallest shred of hope that I may still get my girl after seeing this, but it was just so obvious and so so so clear.

Thank you so much in advance for any advice or insight you can give me. I’m so disappointed in myself for feeling gender disappointment. I didn’t realise how much I wanted a daughter (this is our last baby) until I saw that potty shot.

Please tell me honestly; I can take it!!

Yours very gratefully,
🙂

PS. I think what you are doing for ladies like me is fantastic. I cannot believe I found you after all my searching for answers! An actual professional who answers silly, hormonal women’s questions! Not a forum full of people who claim to know it all and actually know very little! 🙂

 

My Nub Theory Response

wwavb:  Thank you for all the nice things you’ve sent my way;) I appreciate it and am so happy you are enjoying reading my blog!

So, maybe you haven’t yet come across my posts on the subject. Click away! Boys and girls can look EXACTLY alike early on.

The links below will give you more information:

http://wombwithaviewblog.com/early-gender-pics/

Check out the links below for my images of fetal sex which are textbook, classic, no-guesswork-needed images of both male and female sex later in pregnancy:

http://wombwithaviewblog.com/female-gender-on-ultrasound-2/
http://wombwithaviewblog.com/boy-girl/
http://wombwithaviewblog.com/boy-vs-girl/
http://wombwithaviewblog.com/twin-gender-update/
http://wombwithaviewblog.com/third-trimester-male-gender/

All that said, it’s okay to have a preference, but we all get what we need in the end. Having another boy means you needed one another for whatever reason! I hope you’ll subscribe and keep reading at wombwithaviewblog.com😉

Best wishes!
wwavblogger, RDMS

 

Second Nub Theory Email

hormonal mama: Thank you for replying. I’m so grateful! I have posted a link to your blog on our pregnancy group page. I hope it gives some other ladies peace of mind. (And a good giggle!)

I was recently told by an US tech in the group that there is a “nub” on my image. But I am notoriously useless at seeing them. Would you be able to confirm (or deny) if there are any genital parts visible? All I’m seeing is legs and a cord. I know the angle of the dangle is not a reliable theory (from your blog!) but for someone to say she can see it on my scan, it would be helpful if I knew if it was even visible!

Many thanks again and again 🙂

12wk fetus/nub theory

wwavb: Thanks so much! I, too, hope they get some useful info and a giggle, also;)

Does the sonographer in your group practice OB? Experienced or new to OB? I question because I entirely disagree. Every baby has a nub at this age, but one cannot be sure whether the nub represents boy or girl. If she is referring to the thing sticking out near the butt, that is too large to be the nub in question so my thought is it’s baby’s cord.

And actually, to see the nub, the plane needs to be centered between baby’s legs which means you would not be able to see the legs in this view. See the image below:

Suspected Baby Girl at 12wks/nub theory

No legs here! That could be a tiny foot way above the arrow, however.

This tells me the angle on your baby is not perfectly centered and is a little too far lateral whereby the leg is included in the image. I hope this makes sense! What a cutie, by the way;)

Keep me posted!
wwavblogger, RDMS

Final Advice?

It’s entirely possible to get excellent images at 12 Weeks, and this theory is reported to be about 73% correct. If you do the math, that leaves 20+% with potential gender guilt. I only recommend finding out on your NT scan if you can remain mentally neutral!

You can email me also, at wombviewerblog@gmail.com!

 

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Posted on October 20th, 2015 by wombwithaviewblog.com

The Gender Scan – Determining Fetal Sex

I think most of you reading probably would believe that most of the emails I receive have to do with parents wanting me to confirm fetal sex…sometimes desperately so. And sometimes determining fetal sex is an impossible task during the gender scan.

I try to explain in my replies that my guess is only as good as the images they send me. I don’t believe it is quite understood what I mean when I say that ultrasound is entirely subjective, but the person performing the gender scan has total control over the images obtained. The sonographer creates these images utilizing a number of controls to optimize the image. She also uses her own discretion to determine a good angle with the probe she is holding.

Yes, there is a standard here but I have to brutally honest. Just as people excel in some areas of life and/or profession, some are also bad. There are good docs and bad, good nurses and bad, good cashiers and bad. This is a painfully obvious fact when I open these image attachments! It’s also possible these operators are not formally-educated sonographers at all! Read more here on some elective 3D businesses.

In addition, just one angle is not enough to see well. However, only one angle can be depicted in one image at one time. I wasn’t there during your gender scan, so I don’t know anything about the variables that could have made imaging difficult.

I just know a technically bad image when I see one. Sometimes, I can tell an operator did not take measures to improve the image. In those cases, I can only assume that someone did not know how to use them correctly. If the person scanning you is new to ultrasound or not a real sonographer, the image may not appear optimal to someone who is experienced in sonography.

Great Images for Determining Fetal Sex!

Below are some great images of fetal sex that I’ve taken myself.

female fetal sex, 18 Weeks

The above depicts an underside view of typical-appearing female parts from about 16 – 22 Weeks pregnant. The side arrows point to labia, the middle to the clitoris.

 

gender scan

Female labia in the 3rd Trimester

 

male fetal sex, 28 Weeks

Male genitalia, late 2nd Trimester

 

male fetal sex, 3rd Trimester

The above demonstrates a side view of typical-appearing male parts from about 27 Weeks on.

 

So, all that said, if the image you send is not an optimal one, I may not be able to take a guess on fetal sex. Even if your sonographer felt sure of her guess during the gender scan, I may not feel I can agree based on limitations of the image. That doesn’t mean your sonographer got it wrong, just that I cannot concur with the former guess because the image quality is not there. If I didn’t observe the scan myself, I am unable to see your baby’s parts from many different angles!

Below are the links I typically email on my posts regarding fetal sex:

Early Gender Pictures
Boy Vs Girl
Twin Gender Reveal

Until next time, feel free to reply, comment or email with your questions at wombviewerblog@gmail.com! You can also subscribe to the right:)

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Posted on May 1st, 2014 by wombwithaviewblog.com

Early Sex Determination

I find it comical when people ask me my opinion about gender and then don’t believe it. Especially regarding too-early sex determination. They keep asking. And asking. But too early is just. It just leaves too much room for error!

Fetal sex is not well-developed until about 17 Weeks. In fact, too early in the pregnancy, they both have itty bitty parts that stick out and can all look the same. That said, 12 Weeks is way too soon.

Read the emails from the grandma-to-be below who didn’t want to take “it’s too early” for an answer!

g-ma:  Hi, I subscribed to your blog. I love it. These are my grandbaby at 12 weeks 2 days. Any guesses? The baby’s legs were crossed at the 16 Week ultrasound.

12 Week Fetus, early sex determination

12 Week Fetus

12 Week Fetus, early sex determination

12 Week Fetus

 

wwavb:  Hi! And thanks for reading and subscribing! So glad you are enjoying the info!

Okay, so if you’ve read any of my posts on the subject, you know that guessing at 12 Weeks is like flipping a coin. Just too early. An accurate guess can be made at 18 Weeks IF baby is cooperating! Any guess any earlier is simply a guess, and I just wouldn’t invest in paint!

Best wishes for a healthy grandbaby!

g-ma:  Thank you for your response! It’s just driving me crazy wondering what those two white ovals are between the legs. Doesn’t look girl or boy. Could it be fingers or an umbilical cord?

wwavb:  It’s definitely external genitalia, but boys and girls look the same at that age! Over the next several weeks, girl stuff shrinks to form labia and all her girly parts; boy parts get bigger to form the scrotal sac and penis. It’s all still developing on the outside even though chromosomally it’s already determined on the inside.

g-ma:  Thanks for being so helpful. I would think it’s a boy for sure if it’s genitalia! But, not if they look alike at 12 Weeks.

 wwavb:  Sounds like you’re not too far off from finding out. Happy shopping!
g-ma:  Really…No guesses? I know it would be a guess. I thought the pics looked pretty clear. Everyone thought boy.
~*~
This grandma earned a spot in my post for her persistence! But it doesn’t change the facts. The professional verdict was not boy or girl but too early to know. It’s just not all formed yet!
People have a tendency to believe only what they can see or understand. As long as sonographers guess too early and continue to be wrong, I will have to persistently defend my stance on “too early” until the cows come home. It’s especially difficult when someone else delivers a “beyond sure” pink or blue guess to excited expectant families.
I’ll say it again. Weeks 12 – 15 are just too early for a guess that’s accurate enought to invest in paint – unless you’re going yellow!
Email wombviewerblog@gmail.com with your questions!

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