At-home pelvic ultrasound feasible, preferred over in-clinic care

At-home transvaginal pelvic ultrasonography produced diagnostic-quality images in 96.2% of cases and was significantly preferred by participants over in-clinic scanning, according to results from the SELF-GYN1 trial (NCT05443698) published in JAMA Network Open.

The prospective, interventional, single-group nonrandomized clinical trial enrolled 265 premenopausal women aged 22 to 50 years across 11 US states and Washington, DC, with images collected between July 2022 and July 2023. The trial evaluated the feasibility and participant experience of at-home transvaginal ultrasonography guided by a fully trained remote sonographer with real-time image access, extending prior in-clinic noninferiority findings to a broader population that included device shipment and remote use.

Pelvic ultrasonography is a cornerstone of gynecologic care, used in the evaluation of abnormalities and fertility treatment monitoring. Despite its broad acceptance, many patients find the procedure invasive, uncomfortable, or embarrassing.

“These feelings are amplified in specific populations such as those with a history of trauma, chronic pelvic pain, or marginalization, such as lesbian, gay, bisexual, transgender, and queer (LGBTQ+)individuals,” noted the study authors.

Did at-home ultrasound produce clinically acceptable image quality?

Of 263 completed scans, 253 (96.2%) met diagnostic quality standards, while 10 (3.8%) did not. Cine clips were used to capture standard views of the uterus, ovaries, cervix, and posterior cul-de-sac, with a fully trained remote sonographer guiding each participant through the procedure via verbal communication in real time.

How did participant satisfaction compare with in-clinic ultrasound?

Participant net promoter score (NPS), reflecting likelihood of recommending the procedure, was significantly higher for at-home ultrasonography (59) vs. in-clinic scans (24), with an adjusted difference of 33.7 (95% CI, 23.3-44.0; z = 6.35; P < .001). No adverse events were reported across the trial.

The mean participant age was 32 years (SD 6.7) and mean body mass index was 27.0 (SD 5.6). Secondary outcomes included minor pain or discomfort, sonographer-reported experience, and all other adverse events.

What do these findings mean for access to gynecologic care?

The study situates at-home pelvic ultrasonography within a broader shift toward remote diagnostics in women's health, which has already seen expanded adoption of telemedicine and at-home hormone testing, among other areas. Labor shortages and high rates of work-related injury among sonographers add further urgency to scalable alternatives to in-clinic imaging, according to the study authors.

The SELF-GYN1 findings demonstrate that remote ultrasonography guided by trained sonographers is not only clinically feasible but preferred by both participants and sonographers.

“These findings represent an innovative and clinically accurate solution to expansion of at-home care that aims to decrease barriers to care, both individual and systemic,” the authors wrote. “Future studies could focus on the costs of implementation and long-term use of this technology.”

Reference:

Ainsworth AJ, Sacha C, Vagios S, et al. At-Home Transvaginal Pelvic Ultrasonography and Image Quality in Premenopausal Women: A Nonrandomized Clinical Trial. JAMA Netw Open. 2026;9(7):e2621476. doi:10.1001/jamanetworkopen.2026.21476