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Hysterosalpingo-foam sonography: patient selection and perspectives

Authors Rajesh H, Lim SL, Yu SL

Received 2 October 2016

Accepted for publication 24 November 2016

Published 28 December 2016 Volume 2017:9 Pages 23—32


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 4

Editor who approved publication: Professor Elie Al-Chaer

Hemashree Rajesh, Serene Liqing Lim, Su Ling Yu

Centre of Assisted Reproduction, Department of Obstetrics and Gynecology, Singapore General Hospital, Singapore

Abstract: We present an overview of the common types of tubal patency tests, with a focus on hysterosalpingo-foam sonography (HyFoSy). Current evidence suggests that HyFoSy is an accurate alternative to X-ray hysterosalpingography (HSG) for outpatient tubal evaluation in women who are at low risk for tubal disease. It may be superior to saline hysterosalpingo-contrast sonography (HyCoSy) in excluding tubal occlusion. A hyperechogenic medium may enhance contrast visualization and enable clearer delineation of tubal anatomy. This may enhance confidence in the diagnosis of tubal patency, reduce false occlusion results, and improve the diagnostic yield of the test. It would be reasonable to deduce that HyFoSy would have similar performance characteristics as HyCoSy with other positive contrast agents. The available evidence supports the accuracy of HyFoSy compared to other forms of tubal investigation. We suggest a decision-making pathway based on the most current professional recommendations and available evidence. However, in this article, we do not provide a definitive exposition of the methods used for investigating tubal patency. Rather, we explore the contexts in which the various investigations are most and least suitable, and identify their strengths and limitations. Finally, we also discuss challenges encountered when performing tubal contrast sonography in clinical practice, including the problem of false occlusion results.

Keywords: hysterosalpingo-contrast sonography, hysterosalpingo-foam sonography, tubal patency testing, infertility, tubal occlusion

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