Hysterosalpingo-foam sonography (HyFoSy) in the evaluation of tubal patency (original) (raw)
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Middle East Fertility Society Journal, 2022
Background: Tubal patency testing is an essential part of female subfertility evaluation. Hysterosalpingogram is less invasive and less expensive compared to laparoscopy and dye testing (LDT), i.e., laparoscopic chromopertubation. Hysterosalpingo-foam sonography (HyFoSy) uses commercial echogenic gel foam that is easily visible on ultrasound to assess the tubes. It offers a safer and less painful alternative to HSG, with no radiation exposure. Hysterosalpingolidocaine-foam sonography with power Doppler (HyLiFoSy-PD) uses lidocaine-made gel foam as a contrast medium. It was postulated to as to be less painful and easier to detect on ultrasound, compared with hysterosalpingo-foam sonography using other contrast media and that it can also be used whenever the commercial gel used with HyFoSy is not available or is relatively expensive.
First experiences with hysterosalpingo-foam sonography (HyFoSy) for office tubal patency testing
Human Reproduction, 2012
background: This study was conducted to describe the first experiences with hysterosalpingo-foam sonography (HyFoSy) as a first step routine office procedure for tubal patency testing. methods: A prospective observational cohort study was started in a university affiliated teaching hospital. In 2010, 73 patients with subfertility and a low risk of tubal pathology were examined. A non-toxic foam containing hydroxymethylcellulose and glycerol was applicated through a cervical applicator for contrast sonography (HyFoSy). Tubal patency was determined by transvaginal ultrasonographic demonstration of echogenic dispersion of foam in the Fallopian tube and/or the peritoneal cavity. Only in case patency could not be demonstrated, a hysterosalpingography (HSG) was performed as a control.
The Journal of the American Association of Gynecologic Laparoscopists, 2003
Some degree of tubal pathology, resulting in occlusion of one or both tubes, is found in one of three infertile women. Conventional diagnostic imaging procedures such as radiographs, hysterosalpingography (HSG), and laparoscopy with dye pertubation are associated with several risks including invasiveness and exposure to iodinated contrast media or ionizing radiation. Transvaginal ultrasound accurately diagnoses various pelvic conditions that can be responsible for infertility and that are not detectable by HSG, but it does not permit evaluation of the patency of the fallopian tubes. Hysterosalpingo-contrast sonography (HyCoSy) was introduced in the early 1980s for studying tubal patency. It is a simple, easy, outpatient technique that hardly ever requires premedication or hospitalization. In initial studies, saline solution was passed transcervically before performing transabdominal sonography. 1, 2 From the finding of free fluid in the pouch of Douglas, these authors indirectly deduced patency of at least one tube. Saline solution has the advantage of being completely safe and inexpensive. However, although it is excellent for visualizing intrauterine pathology (sonohysterography), it does not seem to be particularly accurate in determining the state of fallopian tubes and their patency. 3-5 Association of transvaginal ultrasonography with color Doppler sonography and/or ultrasound positive contrast media increases the accuracy of this method. Studies comparing HyCoSy and HSG in the diagnosis of tubal patency reported conflicting results, probably due to different ultrasound techniques and contrast media. Contrast media (Echovist, Levovist, Infoson) 5-10 facilitate evaluation of tubal patency by HyCoSy; however, they are expensive, not available in many countries, and not always accepted by patients. Some authors 11-13
BMC women's health, 2018
Tubal pathology is a causative factor in 20% of subfertile couples. Traditionally, tubal testing during fertility work-up is performed by hysterosalpingography (HSG). Hysterosalpingo-foam sonography (HyFoSy) is a new technique that is thought to have comparable accuracy as HSG, while it is less expensive and more patient friendly. HyFoSy would be an acceptable alternative for HSG, provided it has similar effectiveness in terms of patient outcomes. We aim to compare the effectiveness and costs of management guided by HyFoSy or by HSG. Consenting women will undergo tubal testing by both HyFoSy and HSG in a randomized order during fertility work-up. The study group will consist of 1163 subfertile women between 18 and 41 years old who are scheduled for tubal patency testing during their fertility work-up. Women with anovulatory cycles not responding to ovulation induction, endometriosis, severe male subfertility or a known contrast (iodine) allergy will be excluded. We anticipate that 7...
IP Innovative Publication Pvt.Ltd, 2017
Objectives: To find out the comparative evaluation of Sonosalpingography, Hysterosalpingography and Laparoscopy for determination of tubal factors in cases of primary and secondary infertility. Method: A total of 71 patients 45 with primary infertility and 26 with secondary infertility attending our obstetrics and gynaecology department were studied from June 2015 to July 2016. All underwent Sonosalpingography, Hysterosalpingography and Laparoscopic chromopertubation. Chi square tests were used for statistical analysis to find out the sensitivity and specificity of the test. Result: Sonosalpingography has 100% sensitivity and 80.5% specificity in comparision to laparoscopy chromopertubation whereas hysterosalpingography has sensitivity of 94.6% and specificity of 73.1%. Conclusion: As Sonosalpingography has high sensitivity and specificity and is less invasive. It should be used initially to assess tubal patency in case of infertility. Laparoscopy is the best technique for diagnosing tubal and peritoneal disease as it allows direct visualization of all the pelvic organs.
Reviews in Gynaecological Practice, 2003
Tubal evaluation is an integral part of any infertility work-up. Existing modalities include laparoscopy and dye-the current gold standard, and hysterosalpingography (HSG); both are effective methods with significant drawbacks. Hysterosalpingo contrast sonography (HyCoSy) has been compared favorably with HSG in the literature, and has received growing attention as a minimally invasive screening test. Many clinical trials report it to be as accurate as HSG in evaluating tubal function, while maintaining the advantages of ultrasonography as a safe and well-tolerated imaging modality. Others emphasize its superiority in demonstrating ovarian morphology, which is also pertinent to infertility investigation. This review of the literature will summarise the existing data on hysterosalpingo contrast sonography and compare it to existing modalities in terms of accuracy, tolerability, and cost-effectiveness in order to determine whether it can practically replace HSG as a primary screening tool.
Journal of Clinical Medicine
Introduction: Simplified ultrasound-based infertility protocols that appear to provide enough information to plan effective management have been described. Thus, the objective of this study is to compare the diagnostic accuracy of the hysterosalpingo-foam sonography (HyFoSy) in tubal patency testing with the traditional hysterosalpngography (HSG) for establishing a new diagnostic strategy in infertility. Material and Methods: Prospective observational diagnostic accuracy was performed in a private fertility clinic in which 106 women undergoing a preconceptionally visit were recruited. All of them had low risk for tubal disease, had performed an HSG and were negative for Chlamydia trachomatis antibody. Main outcome measures were tubal patency and pain grade. Results: Evaluation of tubal patency by HyFoSy showed a total concordance with the results of the previous HSG in 72.6% (n = 77), and a total discordance for 4.7% (n = 6), with the inter-test agreement Kappa equal to 0.57, which ...
Technical Tips and Tricks after 10 Years of HyFoSy for Tubal Patency Testing
Journal of Clinical Medicine
Background: Hysterosalpingo-foam sonography (HyFoSy) has gained popularity in the last decades, as it represents a feasible, well-tolerated, and minimally invasive method of evaluation of tubal patency in cases of infertility. The purpose of this study was to communicate the technical tips and tricks based on our experience in performing HyFoSy, with the aim to improve the feasibility, to reduce the pain, and to evaluate pregnancy-obtaining rate after procedure. Methods: Our observational study includes 672 patients from infertile couples who underwent HyFoSy for tubal patency evaluation. During HyFoSy, tubal pathway and patency as well as the level of pain were evaluated. A telephonic questionnaire was conducted in order to assess the pregnancy obtaining rate in the first 3 months and more than 3 months after the procedure. Results: The median age in our group was 33.5 years. Most of our patients (61.16%) underwent HyFoSy in the 8–10 days of the menstrual cycle. Tubal patency was p...
Evidence Based Womenʼs Health Journal, 2015
The aim of this study was to investigate the diagnostic value of transvaginal sonography (TVS) performed after office hysteroscopy, for assessing tubal patency in subfertile women, and to compare the findings with those obtained with laparoscopic chromopertubation. Study design This was a cross-sectional study. Patients and methods TVS was first performed for 60 subfertile women to exclude the presence of free fluid in the pouch of Douglas. Office hysteroscopy was then performed in the outpatient clinic with saline distension medium using 80-100 mmHg pressure, followed by TVS again within 20 min to detect the presence of free fluid in the pouch of Douglas. Laparoscopy with tubal chromopertubation was performed within 1 week for all cases. The results of TVS and laparoscopic chromopertubation were compared. Results The presence of free fluid in the pouch of Douglas after hysteroscopy was correlated to the presence of, at least, one patent tube through laparoscopic chromopertubation; there was a significant statistical difference (Po0.001). The test also revealed a sensitivity of 71.2%, a specificity of 100.0%, a positive predictive value of 100.0%, and a negative predictive value of 34.8%. Conclusion The combination of hysteroscopy and TVS in detecting, at least, one patent tube is a good outpatient method for detecting tubal patency. Nevertheless, it cannot ensure bilateral tubal blockage in case of negative test; hence, another method of tubal patency assessment should be offered.
Contrast ultrasonography for tubal patency
Journal of minimally invasive gynecology
Evaluation of tubal patency is an essential part of a fertility workup. Laparoscopy with chromopertubation in conjunction with hysteroscopy is the gold standard in evaluation of tubal patency and the uterine cavity. In this review article we describe a newer method for evaluation of the uterus and fallopian tubes, that is, hysterosalpingo-contrast sonography (HyCoSy). Accuracy of HyCoSy for tubal patency has been shown to be comparable to that with hysterosalpingography (HSG) when compared with laparoscopic chromopertubation. Sensitivity ranges from 75% to 96%, and specificity from 67% to 100%. HyCoSy is also accurate when compared with HSG in determining tubal occlusion after hysteroscopic sterilization, with 88% of patients stating they would prefer to undergo the tubal occlusion test in their gynecologist's office. Because HyCoSy also includes evaluation of the uterine cavity with saline solution-enhanced sonohysterography, accuracy in evaluating the uterine cavity is >90%...