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Guessing Fetal Sex–Gender Ultrasound

Gender Ultrasound–Guessing Fetal Sex

baby gender ultrasound

“How sure are you?” I’ve heard this question probably more than any other in my career during the baby gender ultrasound! Sometimes, guessing fetal sex is a big risk and a real guess. Patients want percentages; I just want to be right! Nothing is ever 100%!

Every sonographer is different. One’s sure is another’s iffy. I’ve seen images where a person was told one sex and the sonographer had “no doubts” only for me to scan later, confirming the opposite gender. The fact is that as long as expectant parents remain interested in guessing fetal sex by ultrasound, there will always be challenges surrounding the task.

You can see a few great images of fetal gender here. 🙂

How Sure Are We When Guessing Fetal Sex?

Are we sure or is it a guess? Honestly, they are all guesses. No sonographer should tell you her guess is 100% accurate. Even genetic tests like 1st Trimester DNA and amniocentesis can brag of 99+% accuracy! We, as humans, sure can’t surpass those odds!

Who we have making all those guesses are new sonographers right out of training, observers with little training, and those who are not formally trained in ultrasound at all (like in some of the keepsake video non-medical ultrasound business). And because reading the scan is so subjective, there will be always be incorrect guesses during the baby gender ultrasound. Even all us experienced sonographers practice a little differently. There will always be those who feel more confident to guess earlier than me. Others are more cautious, examining from every angle but still hesitant to commit if Baby’s legs are partially closed.

I’m more of the latter persuasion. I want to be VERY sure, super-duper sure before delivering a guess to my patients! I need great views in more than one angle and textbook imaging. After all, moms and grandmas want to shop! I would crawl under a rock to know I guessed incorrectly. Mostly, I would feel simply horrible for my patient, knowing it was because of me that she invested (both emotionally and financially!) in one sex vs the other! 😵😣

What’s the Answer?

Those who are new graduates or with limited experience could consult a more-experienced sonographer for a second opinion. And if a patient decides to visit an elective ultrasound business, make sure your sonographer has had formal training!

Patients should not pressure their sonographers for a percentage but also be understanding if she says she cannot determine their baby’s gender. I know! It sure stinks when this happens, but guessing fetal sex is something we can do if we have time and if Baby cooperates! Last but not least, Moms, don’t trust a fetal sex guess from anyone in a non-medical ultrasound facility that does not carry sonographer credentials! RDMS for those who are certified and DMS for those with formal training but who have not yet passed a registry examination. Experience in OB is preferable!

*And a final word of caution! Save your money during Weeks 12-14! Weeks 15-16 can still be “iffy.” Waiting until 18 Weeks and later is always better!*

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And email me at wombviewerblog@gmail.com.

The Gender Scan–Confirming Your Guess

Why Confirming Your Gender Scan Is Tough

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. But sometimes determining fetal sex based on someone else’s image in a gender scan I didn’t perform is an impossible task.

I try to explain in my replies that my guess is only as good as the images they send me. Some people take great images; some don’t. And sometimes, no matter how experienced a sonographer, good images are just not possible! When I explain that ultrasound is entirely subjective, this means 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 whether she can see well enough and whether what she is seeing looks more like Team Pink versus Team Blue.

All Images Are Not Equal

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 not very good at what they do. There are good docs and bad, good nurses and bad, good cashiers and bad. This is a painfully obvious fact regarding ultrasound when I open some of these image attachments! It’s also possible these operators are not formally-educated sonographers at all! Yep, it’s true, and you can read more on the subject of elective 3D businesses here.

When we scan you real-time, we are trying to see from many angles. However, only one angle can be depicted in one image at a 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, gender scan

The above depicts an underside view of typical-appearing female parts from about 16 – 22 Weeks pregnant.

male fetal sex, 28 Weeks, gender scan

Male genitalia, late 2nd Trimester

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!

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Fetal Gender Determination

Sometimes, it’s just Mission Impossible!

Fetal gender determination is not always a walk in the park for us sonographers. Ultrasound, like many technologies, has its limitations. There exist many factors which can make fetal gender determination mission impossible! Your OB docs understand there are a number of variables that prevent good visualization in every ultrasound we perform. Unfortunately, many patients do not.

So, if you’ve been losing sleep in anticipation of this long-awaited news, read this first! My goal is to inform expectant moms so that you go into your ultrasound exams with realistic expectations. I sincerely hope that through understanding these limitations, you’re able to leave your experience feeling happy. If all you can see is Baby’s heartbeat, it’s an opportunity to bond with your new addition that doesn’t come everyday.

Is Fetal Gender Determination a Requirement?

Definitely not. Fetal gender determination is not a routine part of a diagnostic examination. It may be information you desire, but it’s not typically information your physician needs. The anatomy screen at about 18-20 Weeks or so is ordered to rule out structural fetal malformations. Most U.S. practices do not mind providing a fetal gender determination as a courtesy IF the sonographer feels she can see well. And we LOVE to give you this information, if we can!

What Factors Impair Fetal Gender Determination?

Some of these factors that can get in our way of how well we see are listed below. They are very common! Actually, some of them confront us on a daily basis.

  • A breech fetus
  • A fetus with the rear against the uterine wall
  • A foot or feet in the genital region or crossed feet
  • Closed legs
  • The umbilical cord between the legs or against the fetal body
  • Body habitus or too much weight around a patient’s middle
  • Uterine fibroids or contraction
  • A decrease in amniotic fluid
  • Genital malformations
  • Early gestational age

Even one of the above factors can prevent even the most experienced sonographer from determining fetal sex. A good sonographer knows when the views are good enough to provide you with a guess. A good sonographer also knows when not to guess! What you don’t want is someone who is inexperienced but willing to guess anyway. Many times, it’s not just one but several of the above variables that limit what we see. Unfortunately, we can’t change any of them.

Can you appreciate the difference between the first two images and the third?

female gender, 2nd Trimester female gender, fetal gender determination

Great image of female gender!

female gender, 2nd trimester female gender, fetal gender determination

Great image of female fetus!

fetal gender determination

Um, not so much . . .

Another little fact I’ll add here is that a non-arguable truth of the modality is Ultrasound’s laws of physics. The further sound has to travel, the weaker the returned signal. The more tissue the sound waves have to penetrate, the worse the image. In other words, the more tissue there is around a patient’s middle, the more fuzzy the picture. The more fuzzy our picture is, the less we can see Baby’s parts. Any not just fetal gender, any parts. All it takes is one of the above factors to ruin the party. More often than not, a combo of factors will cause a little unwanted rain on your parade.

What Can We Do to Help?

We can try a couple of variables in an attempt to see better. Jiggling your belly or turning you to each side sometimes helps. We do this in the hopes that your change in position will also change Baby’s. Alas, it doesn’t always work. For some tips on how you can try to ensure Baby is a little more active during your exam, click on this link!

What We Can’t Do

Unfortunately, we can’t scan you indefinitely! In an effort for fairness, we always try to get our next patients in as close to their appointment times as possible. Sticking to this schedule can be tough when patients arrive late or when we find abnormalities. Most patients are allotted a 30-minute appointment for their ultrasound exam. However, not all of this time is scanning time.

Before we scan you, we need to examine your chart for your history, an order from your doc, and an indication for the exam. After the exam, we need time to type up your report and send it to the physician. Most of us are nice enough to take more time with a patient if our schedule allows. I always did. Unfortunately, some of my patients (not understanding ultrasound) didn’t think I did!

What You Shouldn’t Do!

internet search of fetal abnormalities

An unreasonable action disgruntled patients take these days includes airing their rants on social media. Consider, first, that venting your frustrations reflects poorly on your physician and practice. And you could be fired. Yes, a patient can be fired! In other words, I would advise against this method of revenge. If you are unhappy, you have the right to discuss it with Administration. But just know a practice does not have to tolerate any behavior deemed irrational or unreasonable. Just like one can fire an attorney, a plumber, or doctor, a patient can find herself in the same situation.

A Modern-Day Problem

Unfortunately, our society has become one of immediate gratification, even demanding it in the face unreasonable circumstances. I’m reminded of a few former patients and a like-minded character from one of my favorite childhood movies. Anyone remember Veruca Salt of Willy Wonka fame? These patients actually got angry, yelled, cried, and ranted in a place of medical business, much like the toddlers they would have themselves in another couple of years – all because I couldn’t tell them the sex of her baby. This. Is. Unreasonable.

I realize some sonographers don’t try very hard. In most circumstances, however, most of us make a sincere attempt to obtain this information for our patients who want it. We cannot, however, change the laws of physics.

Moreover, some patients mistakenly assume that because we couldn’t make a fetal gender determination, we must not be able to skillfully perform their diagnostic examination otherwise. Please keep in mind that medical professionals never judge such as gross incompetence. Rather, ranting such on social media is reflective of the patient’s lack of understanding of how the technology works. So, please! Don’t do this. 🙂

We hate when our patients leave foaming at the mouth. Remember, this scan is about Baby’s health first! Just ask any mom who didn’t have a healthy baby.

Good luck for a great sonogram!

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Male Gender–19 Weeks

Male Gender on Ultrasound

What should you expect to see?

You’ll need to look no further than the photos I have for you below–two great images of male gender! This baby was about 19 Weeks and (no pun intended), boy, was he proud!

male gender, 19 Weeks pregnant

The image above represents a bottom view. Just imagine Baby sitting on a glass table as you look up from the underside. I have all the parts labeled for you. The arrows, of course, point to the wee-wee (my very medical term). This pic is about as straightforward a potty shot as you will find. No guesswork–all boy!

male gender, 19 Weeks pregnant

Now this is a side view of Baby. You can’t see his head in this picture which would be off to the left-hand side. Again, I’ve  labeled all the parts so that you, hopefully, understand what you are seeing. I realize it’s much harder to look at an image than to have someone right there, narrating it all for you in person.

This time it’s the legs which do not make an appearance here. Not to be graphic but for demonstrative purposes, imagine slicing the body in half lengthwise; this is the view we see here–right down the middle of the torso.

male gender, 19 Weeks pregnant

The penis and scrotal sac from the side resemble a turtle sticking out of his shell. So, appropriately enough, patients would always ask for a turtle shot. If you can appreciate the tiny dotted line, you will see it is drawn around the “turtle.”

You can see how parts look different from different angles. These depict super great images of baby boy stuff . . . no question, no nonsense, no guess work. Just how I like ’em. And just all boy!

Best wishes for a healthy baby on your next scan!

As always, thank you for reading!
And you can email me with your questions at wombviewerblog@gmail.com.