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Deciphering Male Fetal Sex

Male 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! male gender, male gender guess, male fetal sex

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. It’s just 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 from the start.

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 male. Her images didn’t leave much of a question in my mind! She was just over 20 Weeks along.

Can you tell this is a boy?

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 this 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 view!

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!

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Facial Profile on Ultrasound

The fetal facial profile on ultrasound is one of the shots expectant parents look forward to most. Unfortunately, they are not always possible to obtain! I totally get it. When we meet someone, we meet their face first — it’s entirely understandable the parents-to-be just want to see their Baby’s face.

Oftentimes patients express disappointment with a profile image because “baby wasn’t looking at the camera.” Some think they want the front view of the face, but it looks scary to most parents!

facial profile, fetal face

Just what I thought you’d say–a face only a mother could love! Truly, some moms don’t care and want positively anything we can get! I always tell them that seeing the face from the front mostly yields a skeletal appearance…eye sockets and triangular nasal bones – very “jack-o-lanternesque.”

Unless the shot is a 3D image, the profile or side view of Baby’s face is the one to shoot for in 2D. In this plane we can see the soft features of the face like the nose and lips that look more like a baby.

Since amniotic fluid is ultrasound’s best friend (and mine), we need a nice pocket of fluid in front of your baby’s face to see it well. If baby is facing your back or if it’s smushed into the placenta, unfortunately, face images may not be possible. It will be a “no paparazzi” day for Baby. This means you’ll likely get some precious images of hands and feet to take home. Let me just say I love some baby toes! But patients feel a bit let-down when the little diva doesn’t cooperate.

Great Images of a Fetal Facial Profile on Ultrasound

If you ever felt confused by a profile on ultrasound, the images below provide an explanation of two great ones! Both of these babies were just over 20 Weeks.

fetal profile, facial profile, 20 weeks pregnant

Fetal Facial Profile at 20 Weeks

In the image above, a little more fluid (the black stuff) in front of the face would have been helpful. As you can see, the tip of the nose and forehead just barely touch the uterine wall and placenta in front of it. However, it’s still a great shot!

 

fetal profile, facial profile, 20 Weeks pregnant

Fetal Facial Profile

How about this one?! PERFECT! This is an absolutely beautiful textbook image of a fetal profile. Can you appreciate how there is more fluid in front of this baby’s face?

Finally, if only ALL the babies I scanned looked like this … SIGH. Such is life. I suppose if every fetus cooperated like the one above, I’d never get any real work done! Mama would sure be happy, though, with a string of pics a mile long. 😉 Who doesn’t love a photogenic fetus?

***

Here’s hoping you’ll have great pics of your baby come anatomy screen time. And if you need more info on what visitors to take with you along with suggestions for that all-important test, just click here.

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

 

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.

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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Early Pregnancy Questions–Ultrasound Gender

Your Early Pregnancy Questions Answered
… or Not

You know, I just don’t have all the answers. I know you may not be terribly shocked by this revelation! That said, I get emails all the time with partial tidbits of relative info from which I am supposed to glean an opinion or diagnosis. Sometimes, it’s just not enough to read between the lines, especially with regard to early pregnancy questions or early gender. See the emails below to understand why I just cannot answer some of them!

Early Pregnancy Questions (1)

Vague Mama:  Hi My name is _______.
Here’s my ultrasound.
Thank you in advance.

***

The subject of this email read 12w6d ultrasound. I can only assume this reader was curious about gender, but she didn’t really ask the question. Below you’ll see the images she sent. Can you tell that they are super bright?? Take my word for it; they are! These are the epitome of poor quality. Believe me when I say someone didn’t learn how to scan well.

early gender, early pregnancy questionsearly gender, early pregnancy questions early gender, early pregnancy questions

Now compare those to an image I took below. Even though the baby here is a lot further along (about 20 Weeks), I’m sure you can appreciate the difference in brightness. Even a new sonographer would appreciate the contrast, and you don’t have to be able to read ultrasound to see how different they appear. It’s very likely her images were taken by someone with little ultrasound training.

early pregnancy scan

Great ultrasound imaging can only be taught. Truly. I can only speak from experience! We all were terrible in the beginning of our education! Unfortunately, she was just too early, and the images were too poor to take a crack at fetal sex. I hate when that happens.

Early Pregnancy Questions (2)

Twin Mama:  Wow! So glad I found you. Can you please help with my twin ultrasound? We are confident that baby B is a BOY! However, baby A is leaving us confused. We were told possibly boy, as well. All guesses on other sites say girl. Just so confused. Thank you in advance for your help. Sincerely . . .

***

Nice! This one clearly asks the gender question. However, she didn’t include gestational age, so I have to guess based on how big the baby looks in the image. If you guys know me by now, I do not guess gender before 17-18 Weeks. I’ve only guessed at 16 Weeks a handful of times in my entire career.

Too early = too much guesswork = a wrong guess.
I hate it when this happens, too.

The above represents my professional and very scientific formula on how to incorrectly determine fetal gender. Turns out these babies were 14w4d. In other words, flipping a coin might give you the same percentage of accuracy. And it’s free! There’s not much worse than paying someone to be wrong. Right?!

Early Pregnancy Questions (3)

Concerned Mama: I just have a couple questions I’m hoping you wouldn’t mind helping me with. I just had my first ultrasound abdominally and also had the internal, as well, for dating. My period is very irregular, so I don’t know my LMP. I had gotten lab work done the day before the ultrasound to check my HCG levels. The nurse said they were pretty up there but not yet 14 Weeks.

During my tests, my sonographer would not give me any info. I understand they formally cannot give an official diagnosis, but she wouldn’t even show me the screen. Is it normal that they don’t give you a picture, either? If you could try and answer these questions the best you can, I would greatly appreciate it. 🙂 Thank you so much!

***

So, a non-medical mama may not understand the difficulty here. But, unfortunately, I just don’t have all the information to tell her what she wants to know most. With no images, no measurements, no LMP (Last Menstrual Period), and without her medical chart, I cannot tell her anything she doesn’t already know about her case. I cannot even be sure a heartbeat was seen. And without that all-important data, I can assume nothing.

The only opinion I could really offer her is that it’s really tough to have to wait for results in such circumstances. In this case, my reader had to wait an entire weekend for some answers. Not. Okay! It turns out the pregnancy wasn’t a good one which is likely why her sonographer didn’t turn the monitor her way. This is always a terrible position to be in for the sonographer and the patient.

I really believe patients should never have to wait days for this kind of result. However, giving results depends on protocol–and every facility does this differently. Usually, a radiologist reads the scan and sends a report to her obstetrician. Maybe she went to the ER, in which case the report would have gone to the ER doc first, then to her obstetrician. Alternatively, the scan could have been performed in her obstetrician’s office. But if her doc wasn’t there that day, it’s possible that her doctor needed to review the ultrasound prior to giving the patient her results.

More on Your Early Pregnancy Questions

So, Ladies, just know that sometimes I can’t help you very much, but I always try! Include as much information as you can about your experience, and I’ll do my best to help you make sense of it!

‘Til next time, here’s wishing you a happy healthy sonogram. 😉

Please email me at wombviewerblog@gmail.com with your questions or comments!

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Unknown Gender–To All Except the In-Laws

Is unknown gender still a secret . . .

if your mother-in-law thinks she can read your images?

We all know that our family and friends can be quite nosy, opinionated, and even rude when it comes to all things pregnancy-related. After all, they’ve been there and done that, and they know better than you. This is your first rodeo, and you know absolutely nothing. Sound familiar?

In the course of conversation during a scan, especially with my weekly patients, we glide from the political correctness and appropriate medical office pleasantries to cutting up about life happenings. My patients take this opportunity sometimes to vent about just such personal offenses. One of my readers recently did the same! Read on about her dilemma . . .

irritated mama:  Hello! Firstly, I would like to say what a great blog you have, and I’ve really enjoyed reading it. Secondly, I’m wondering if you can take a look at my scan pic from my 20 Week scan. I’m now 25 Weeks. We didn’t find out the gender as my husband didn’t want to, but his family is convinced it’s a boy from the scan pic. They are even calling it a “he” which is quite annoying. I’m just wondering if there is anything on this scan pic that confirms the gender? Obviously, we didn’t get a potty shot. I hope you can help. Thanks!

unknown gender, 20 Weeks pregnant

wwavb:  This email cracks me up! You are not the first to be annoyed by in-laws who think they are ultrasound aficionados! Everyone is suddenly an expert. You’ll be happy to know gender is nowhere to be found on this image! It’s a great side shot of Baby, but when you get down to baby’s bottom, part of the hip/leg is pictured. So, it’s not a side shot between the legs. Now you can tell your in-laws to mind their own biz!

irritated mama:  Brilliant, thank you. That settles it, and I will tell them just that. Haha!

***

So just know, all you pregnant moms out there with in-laws who are driving you to drink . . . first, I can’t condone escaping your in-laws with wine in your delicate condition. Second, you have to stick up for yourself! There are nice ways to say anything. So, next time your mother-in-law (who doesn’t know what a femur is) attempts to read into your ultrasound image, kindly thank her for her oh-so-professional interpretation, and ask her if she’d like to deliver her grandchild while she’s at it, too. 🤣

Yes, I am a smartass at times, but I blame my brother–the ultimate King of Smartassness, one-liners, and wisecracks. It’s a crown he wears proudly.

You can email me at wombviewerblog@gmail.com with any ultrasound questions you have!

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Male Fetal Gender on Ultrasound

Another Great Male Fetal Gender Pic

It’s a Boy!

Male fetal gender on ultrasound is pretty obvious here, wouldn’t you say? This grandma wrote in to update me on the questionable sex at a 12 Week scan. If you’ve read many of my posts on attempts for early gender guesses, you know there’s no hugely reliable method for determining sex at that age. It’s all theory (the Nub Theory) and hypotheticals and not enough accuracy to start planning your Gender Reveal Party.

Little boys are an easy guess when they pose like this! Not much question here, right? I love it when your babies cooperate!

male fetal gender, 20 Weeks pregnant

This baby was about 20 Weeks here in the above image. He obviously positioned himself perfectly to obtain a great underside view with part of his thighs in the pic. This is exactly what I like to capture when I type “oh, boy!” on the monitor.

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The Perfect Male and Female Ultrasound Images

Wanna See Perfect Male and Female
Ultrasound Images?

Look no further!

Here, I’ll clarify what constitutes REALLY GOOD male and female ultrasound images. If you guys read my blog on a regular basis, you already know how many emails I receive from parents wanting a second opinion on gender images only to get a “I’m really sorry, but I just can’t see well” instead of the confirmation they anticipated.

Most of the time, their sonographer gave the nod for male or female followed by handing them an ultrasound image which looked like a snowstorm. I’m afraid it’s just not quite the validation I can support! I’ve posted other great male and female ultrasound images and gender shots throughout the site, but let me add a couple more.

A Beyond-Perfect Male Gender Pic

male and female ultrasound images, male gender, 20 Weeks pregnant

Hello! Any guesses? I’ll give you only one, but I think you won’t need more than that. THIS is the boy shot patients want to see. This is the holy-cow-look-at-that-wee-wee or he-is-so-proud! shot we always try to obtain.

I’ve labeled the parts, but I realize you probably don’t need that assistance, either. Is there REALLY any question in anyone’s mind here? I didn’t think so. This baby boy is about 20 Weeks in the photo you see here.

Perfect Female Gender Pics

Second Trimester

22 Weeks female gender, male and female gender ultrasound images

Anybody not see three lines here? There’s a little dotted circle around the labia and clitoris in the middle depicting the three lines you hear most about. So. Girly. Enough said.

This little Sweet Pea is 22 Weeks here. She really didn’t want to move her legs for us initially, but I could still see well enough to reconfirm Team Pink for this couple!

 Third Trimester

And this one I’ve posted before! The female labia are much more plump closer to that due date! This baby girl was about 38 Weeks here and probably represents THE most clear female gender image I’ve ever obtained.

38 Weeks female gender, male and female gender ultrasound images

See the difference? I never like to guess gender, and these images leave no room for guessing. I love it!

Even the most ultrasound-challenged won’t argue with these textbook images of fetal genitalia. Everyone who desires to find out fetal sex wants a great photo of those parts, but second to that is a sonographer who knows when the view isn’t good enough for a guess!

Do you have great images of male and female gender you’d like to share?
Perfect!

Email them to me at wombviewerblog@gmail.com!

If you’d like me to review your images, I’ll do my best!
First, please Subscribe then follow the instructions from there.

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