A comparison of patient tolerance of hysterosalpingo‐contrast sonography (HyCoSy) with Echovist^®‐200 and X‐ray hysterosalpingography for outpatient investigation of infertile women

Abstract

The aim of this study was to assess patient tolerance of two outpatient tests. Sixty-six infertile women were prospectively randomized to hysterosalpingo-contrast sonography (HyCoSy) (n = 34) or X-ray hysterosalpingography (HSG) (n = 32). The procedures were performed by the same operator. The uterine cavity outline and tubal patency were determined by both procedures. The mean times taken and the volume of contrast medium required for HyCoSy and HSG were similar: 12.1 +/- 5.2 and 9.5 +/- 4.8 min and 9.4 +/- 5.2 and 11.5 +/- 8.4 ml, respectively. Side-effects were assessed during the procedure, at 2 h, 24 h and 28 days. The most common side-effect was pelvic pain, in 56/66 (84%) women, occurring during the procedures (HyCoSy 19/34 (56%); HSG 23/32 (72/%)) and/or in the following 24 h (HyCoSy 14/34 (41%); HSG 15/32 (47%)). This was described as less severe or equal to their usual period pains (HyCoSy 100%; HSG 85%). Only 12/66 (18%) women required simple non-steroidal analgesia (HyCoSy 8/34 (24%); HSG 4/32 (13%)). There were no significant differences between the two methods concerning the frequency or severity of pains at different stages during and after the procedure or analgesia requirements. HyCoSy and HSG are equally well tolerated outpatient procedures for assessing tubal patency and uterine abnormalities. In addition, HyCoSy avoids the risks of ovarian irradiation and allows scanning of the uterine corpus and ovaries at the same time.

Pain and side effects associated with 4-dimensional hysterosalpingo-contrast sonography for evaluating of the fallopian tubes patency

“…Despite many patients reporting pain during the procedure, all of the patients reported satisfaction with the procedure. Prior articles documented that the mean times (12 to 13.9 minutes) and the contrast agent doses (5 to 15 ml) for 2 D HyCoSy [5,[20][21][22]. In our research, the longest whole assessment time attained 30 minutes, and the maximum SonoVue dosage arrived at 37 ml, primarily due to lack of experience in the beginning.…”

“…HyCoSy exhibits high general accuracy in the assessment of both uterine cavity morphology and tubal patency [3][4][5][6][7][8]. Moreover, HyCoSy prevents both equally being exposed to ionizing rays as well as injection of iodinated contrast medium which could possibly result toxic.…”

“…Moreover, HyCoSy prevents both equally being exposed to ionizing rays as well as injection of iodinated contrast medium which could possibly result toxic. Additionally, it can be performed during an out-patient visit, safe, nicely accepted, reduced examination times, and also potentially less side-effects as compared to hysterosalpingography (HSG) [5]. HyCoSy can also be used as a means of therapeutic treatment for infertile women.…”

3D Ultrasound Assessment of the Uterus: Why an Accuracy Study for Mullerian Congenital Anomalies is not Feasible, while Screening Already is, and should be done

“…A procedure-related pain occurs in up to 72% of patients undergoing HSG for the investigation of infertility [12]. The procedure may be complicated by pelvic inflammatory disease, especially if there is evidence of tubal disease when the test is performed.…”

“…Hysterosalpingo-contrast-sonography (shortened to HyCoSy) is a safe and reliable alternative to the conventional HSG, using no radiation or iodinated contrast material, but an agitated saline/air mixture [12]. If a non-iodinated contrast foam agent (called ExEm Foam) is used, the test is referred to as a HyFoSy procedure.…”