Ultrasound Gender Determination

Ultrasound Gender Determination ~
Pink or Blue?

Ultrasound gender determination can be tricky! Especially too early in pregnancy. Or any time they just won’t cooperate!

gender determination

Female Gender 16 Weeks

male gender, 16 Weeks pregnant

Male Gender 16 Weeks

How many times have all you moms out there, young and old, heard the story that goes, “They told her it was a ‘this,’ and they decorated an entire nursery, and it came out a ‘that’! Those ultrasounds are wrong sometimes, ya know!”

A dollar for every one of those comments would buy me my dream cottage on the Amalfi coast! However, I understand why this happens, and sonographers everywhere need to apply more discretion. First of all, you may already know that it’s not the machine that’s wrong. The sonographer or observer scanning you evaluates what she (or he) sees and determines Baby’s sex. The whole process is entirely subjective! And inexperience sometimes causes sonographers to excitedly guess or, otherwise, cave to the pressure from anxious parents. Unfortunately, sometimes guess incorrectly.

Advice Regarding Gender Determination for the New Sonographer

First rule of thumb for any newbie sonographer out there . . . don’t guess! Don’t put a percentage on your guess, and don’t say “I think.” Also, don’t say “It kinda looks like ‘this,’ but let’s wait until next time.” Parents may want you to guess, but they also want you to be right! Just a word of caution here–some patients may become upset with you if you don’t guess. But if you’ve exhausted your bag of tricks and you still are not sure of what you are seeing, you owe it to the patient to explain this. It’s something you have no control to change, and you would rather they not become attached to the wrong sex. Hopefully, they will understand!

Psychologically and emotionally speaking, most parents start to really become attached to one sex or the other. They begin to envision the first dance recital or baseball game by the time the next ultrasound exam rolls around. On more than a few occasions in my career, someone else guessed incorrectly (usually, too early!), and I had to be the bearer of bad news. After witnessing the affects of “mistaken identity” (shock, anger, tears, sadness, guilt), I adopted a personal policy long ago to only offer a guess when parts were obvious. In other words, Baby had to be in a great position to easily see a penis and scrotum or labia/clitoris. Even though my policy upset a number of my patients in the past, I truly believe refraining from tossing out any old guess is in their best interest and can save them some heartache later.

True Story!

One grandmother, so excited by the doctor’s early guess, flew right out and bought thirty-two dresses! Yep, 32. She did so despite the doc’s warning about his level of confidence and told her to wait for the sonogram with me. Fortunately, he got lucky with his baby girl guess, and grandma was a very happy woman (and a little less rich)! However, you can imagine the disappointment in returning all those frilly frocks if doc was wrong. I always hated giving such news!

Please, all you excited moms-to-be, remember your sonographer doesn’t withhold information about fetal sex just because! We’d actually really rather all our babies cooperate quickly and easily! It’s such a bummer for us both when they won’t. You can’t plan all the fun things you imagined you could. Shopping, party planning… And believe me, I always preferred when my patients left my room hugging me instead of cursing my existence. A magic trick to make Baby flip on command? It’s too bad we aren’t bestowed with super powers upon certification!

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Male Gender on Ultrasound–When the Cord Gets in the Way

Sometimes, little boys just aren’t as obvious …

2nd trimester male gender, male gender on ultrasound

… inside the uterus as they are outside of it. Male gender on ultrasound can be difficult to discern if other parts are in the way. And there’s just not much room in there for the plastic Hefty superman cape of the garbage can variety.

I know my patients over the years would have been thrilled to decipher baby parts on the monitor all by themselves. If they could only read that fuzzy gray and white image, they’d feel much more assured of the whole boy or girl thing. How many times has a sonographer pointed out gender to all you moms during your sonogram and you respond back with a “Uh, where?” Well, you’re not alone in that boat. Check out this email from a mom who had the same problem:

Mama’s Email:

confused mama: Hello! I just recently paid for a gender ultrasound which I was so excited to finally get. But I had an uncomfortable experience with the ultrasound technician. The second she saw the baby she said I am 100% it is a boy. She didn’t show me, my mom, or my mother in law the penis or scrotum, and she didn’t explain at all.

I was 19 weeks and 2 days at the time of this ultrasound. I might be in denial it is a boy, but I’m honestly confused by the photo she gave that shows the penis and scrotum. There are two lines underneath it. But in all the boy ultrasounds I have seen, the penis and scrotum look more defined. It might be the butt, I’m thinking, but I don’t know. Can you please give your professional opinion? I had a friend who is also a RDMS, and she said she could not tell the gender. I am debating if I should do another gender ultrasound. Please help!

male gender on ultrasound, 19 weeks pregnant, male gender, 2nd trimester, second trimester gender

My Response Below:

wwavb: Okay, so check out the image below.

male gender on ultrasound, 19 weeks pregnant, male gender, 2nd trimester, second trimester gender

You are seeing an underside view of Baby. Encircled in yellow is the cord which lies between Baby’s legs and obscuring parts somewhat. His parts in all their glory should stand out a little better with my annotations. I wouldn’t go for another, especially if it’s one of those non-medical ultrasound drive-thru’s.

Does your friend not do OB/GYN? I felt it was pretty easy to tell, but I would have either not given this image to a patient or otherwise explained the parts.


I think some sonographers forget that not everyone can figure this stuff out as easily as we can. Even if a sonographer can boast of experience and certification but specializes in aspects of sonography which are not OB, a guess can still be quite a challenge for them, too. After all, experience is the teacher, right? ANY sonographer who is brave enough (or stupid enough) to call anything between the legs 100% will one day learn this the hard way. Anyone experienced in medicine, or sonography, can attest to the fact that nothing is 100% in any testing arena … even DNA and amniocentesis are only 99+% accurate for gender. As flawed as we humans are, it’s for this reason and the nature of this technology that will never guarantee better accuracy than genetic blood and amnio results.

As sonographers, if we’re going to state how sure we are about gender determination, we should always narrate for our patients when Baby is feeling a little shy that day. And patients, if you can’t tell a penis from a big toe, speak up! Most of us are more than happy to show you around.

And especially when you pay for a 3D elective scan (I’m not a fan of some of these–please read why in the link above!), you have the right to see the monitor with full explanations. After all, you paid for it!

If you have questions for me, just email them here.

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Thanks for reading, and I hope you’re enjoying the new site!

Third Trimester Male Gender

Male Gender Pics–As Clear As It Gets

Today’s message is short and sweet. Third-trimester male gender can be so easy to see–most of the time! However, we still have to deal with all the other factors that can limit views … like a decrease in amniotic fluid (which naturally occurs) and a much bigger baby than what you saw in the 2nd Trimester during your anatomy screen. The combo usually means Baby’s butt is squeezed up against the uterine wall.

And if Baby is breech? You can probably forget about getting another gender confirmation. We have a hard enough time seeing anything crammed down low in your pelvis. A full-grown fetus is no exception!

So, if it’s a great “turtle shot” you wanna see, look no further than the one below. This baby boy is 37 Weeks here.

third trimester male gender, 3rd trimester male gender

Even though I do not believe this image requires annotation, I’ve labeled all the parts so as to avoid confusion for some. In other words, this pic represents about as clear as an ultrasound image can get! The side view of these parts creates the idea of a “turtle.” Can you see it here? The scrotal sac would be the turtle’s shell, and the penis would represent the turtle sticking out of his shell. Either way, it’s a perfect pic of boy stuff.

One of the testicles can be seen here as a brighter gray and rounded area inside the scrotal sac. The penis, well, I do believe it speaks for itself. Now that doesn’t really need arrows now, does it?

If you’re 37 Weeks, hang in there, Mom!

Best wishes for an easy peasy labor & delivery!

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