ULTRASOUND HYSTEROSALPIGORAPHIA

According to medical data, tubal abnormalities account for up to 40% of female infertility. Tubal tests are therefore considered essential in the investigation of infertility, as they provide valuable information about a woman's fertility. The most common methods for assessing tubal patency are X-ray hysterosalpingography (HSG) and hysterosalpingo-contrast sonography (HyCoSy). Until recently, our options were limited to conventional hysterosalpingography (HSG), which is performed in a radiology department using X-rays and a contrast medium introduced through the cervix. Despite the useful information it provides, this method involves increased radiation exposure and a risk of allergic reaction to the contrast agent. Women also describe it as "unpleasant", and it often causes discomfort during and shortly after the test.

HyCoSy and, later, HyFoSy (which uses a gel foam as the contrast) were introduced as an alternative to HSG, avoiding the risks of iodine allergy and X-ray radiation. These ultrasound-based techniques allow tubal abnormalities to be detected in real time and are safer for the patient. Ultrasound salpingography is the most up-to-date technique for checking tubal patency, using a foam contrast agent (HYFOSY) that is easily seen during transvaginal ultrasound.

What are the advantages of HyFoSy?

• No radiation or iodinated contrast material is involved.
• It is painless, with minimal to no discomfort during the test, as the injected fluid causes less irritation than the dye used in HSG.
• It does not require a hospital stay or a general anaesthetic,
• The ultrasound scan allows other pelvic structures to be assessed

How exactly is HyFoSy performed?

First, a transvaginal scan is performed to assess the pelvic anatomy. A speculum is then placed in the vagina and the cervix is cleaned with an antiseptic solution. Next, a thin sterile plastic catheter (2mm) is passed through the cervix. Once the tip of this catheter is in the uterine cavity, the small balloon at its tip is inflated to hold the catheter in place. The speculum is removed and the vaginal probe is inserted again. The scan is performed while the foam gel is injected through the catheter, allowing the fallopian tubes and the surrounding pelvic areas to be visualised.

How long does the procedure take?

The procedure usually takes about 10-15 minutes.

When is the best time to have HyFoSy?

It is best done between day 5 and day 10 of the menstrual cycle, counting the first day of your period as day 1.

Will I need pain relief for the procedure?

A single dose of 2 Nurofen tablets, or similar, – 1 hour before the test is recommended. If you cannot tolerate anti-inflammatory medicines, 2 Panadol tablets can be taken instead. Some women find the procedure slightly more uncomfortable than others.

Will I need to take antibiotics before the procedure?

This is generally not necessary. However, it may need to be considered in some cases, and you should discuss it with your doctor. The prescription is given by your doctor, and the antibiotics should be taken 2 hours before the test.

What else should I know about the procedure?

You may have some vaginal discharge for about 24 hours after the procedure. Most women tolerate the procedure well, although some have stronger cramps. For this reason, you may wish to bring a support person with you who can drive you home.

In summary

Foam ultrasound salpingography (HYFOSY) is generally considered a safe and effective procedure for assessing female fertility. It is a non-invasive technique that combines ultrasound imaging with a foam contrast agent to assess the uterine cavity and the fallopian tubes.

• Safety: HYFOSY is considered safe and complications are rare. The procedure is usually performed as an outpatient, and the use of ultrasound and foam contrast reduces the risks associated with radiation exposure compared with traditional X-ray procedures such as hysterosalpingography (HSG).
• Effectiveness: HYFOSY is effective at providing real-time images of the uterine cavity and the fallopian tubes. It can help identify issues such as blockages, abnormalities or other factors that may affect fertility. The foam contrast agent enhances visibility and improves the accuracy of the test.
• Patient comfort: Compared with some other fertility tests, many women find HYFOSY more comfortable. It is generally considered less invasive and less uncomfortable than procedures such as hysterosalpingography.
• Diagnostic value: HYFOSY provides valuable diagnostic information for healthcare providers. By imaging the reproductive organs and detecting any abnormalities, it can help diagnose fertility-related problems, allowing better-informed decisions about suitable treatment options.

While HYFOSY is generally well tolerated and safe, it is important to discuss any concerns or questions with your healthcare provider before undergoing the procedure. Every person's situation is unique, and your doctor can provide personalised information based on your medical history and your specific fertility concerns.