Health-care providers undertaking ultrasound examination in a center for reproductive medicine will often face a working environment that is far from the traditional radiology-based ultrasound service. However, in order to ensure a high-quality service and to safeguard patients, the same principles of governance and quality standards must also apply to in vitro fertilization units. Every center for reproductive medicine should have and follow standard operating procedures and key performance indicators that represent fundamental tools that help clinicians carry out routine procedures efficiently and ensure quality output and uniformity of performance. In order to ensure an optimum ultrasound quality service, it is mandatory that the equipment is properly maintained (from routine maintenance and daily cleanliness to detailed performance testing). The setting should also be appropriate (room size and temperature, position of the scanning equipment, ergonomic workstation). The sonographer is required to have adequate technical skills, and appropriate image labeling and archiving are his or her responsibility. At the end of the procedure, a good report of the outcomes should be written. It represents an integral part of the whole examination and should be accurate, clear, concise, and logically structured.