Vaginal speculums are made in different sizes and shapes. Most gynecology offices will have a variety of speculums to choose from to limit (patient) discomfort during this exam.
The gloved hand separates the labia of the external genitalia and the speculum is carefully inserted into the vaginal vault. When the speculum is inserted the blades are opened, the walls of the vagina can be inspected, the cervix (at the base of the uterus) can normally be identified, and the cervix is generally centered between the blades of the speculum (to allow for procedures like the pap smear, postcoital test, endometrial biopsy, intrauterine insemination, hysterosalpingogram or hysteroscopy).
Vaginal causes of infertility can be assessed or largely ruled out with the vaginal speculum examination.