Evaluation of tubal patency by hysterosalpingo-contrast Sonography (HyCoSy): Controversies, dilemmas and considerations

Xu, Zining; Wang, Yao‐Ting; Sun, Juan; Chen, Shuangxi; Zou, Yan; Lin, Chi-Chung; Shu, Jing

doi:10.1016/j.heliyon.2023.e17461

Cited by 3 publications

(3 citation statements)

References 57 publications

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“…Partial obstruction refers to the state between patency and complete obstruction ( 37 ). A partially obstructed fallopian tube can affect all of the above processes, leading to infertility or ectopic pregnancy ( 38 ). Most of studies related to partial obstruction of the fallopian tube partly obstruction have been based on HyCoSy ( 34 , 39 , 40 ).…”

Section: Discussionmentioning

confidence: 99%

Evaluation of tubal patency based on peak injection pressure in four-dimensional hysterosalpingo-contrast sonography among infertile females: a preliminary study

Wang,

Chen,

et al. 2024

Quant Imaging Med Surg

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Background Although the application of four-dimensional hysterosalpingo-contrast sonography (4D-HyCoSy) has relatively good diagnostic accuracy for assessing the patency of the fallopian tubes, the evaluation process mainly relies on morphological findings of the fallopian tubes and pelvic cavity. The purpose of this study was to explore the relationship of peak injection pressure during 4D-HyCoSy and tubal patency to provide a quantitative indicator for the evaluation of fallopian tube patency. Methods This study included infertile patients who underwent 4D-HyCoSy and laparoscopic chromopertubation (LC) between 2020 and 2022, with LC serving as the reference test for assessing tubal patency. For the HyCoSy procedure, the ultrasound contrast agent was injected automatically using a liquid injection machine, and real-time pressure values were recorded. Patients were classified based on tubal patency status in LC as bilaterally patent, unilaterally patent, or bilaterally nonpatent. The average peak injection pressure and contrast agent volume of different groups were compared. Receiver operating characteristic (ROC) curve analysis was employed to determine the cutoff value. Results A total of 268 infertile patients were enrolled in the study. With LC as the standard examination, the sensitivity and specificity of 4D-HyCoSy in diagnosing nonpatent fallopian tubes were 91.1% and 95.1%, respectively. In general, peak injection pressure was observed to gradually increase as tubal patency decreased (P<0.001), with average peak injection pressures of 233.5±66.3, 338.8±99.8, and 469.6±63.1 mmHg in the bilaterally patent, unilaterally patent, and bilaterally nonpatent groups, respectively. The volume of contrast agent used in patients in the bilaterally nonpatent group was significantly lower than that in the other two groups (P<0.01), with average volumes of 22.7±6.3, 24.3±9.3, and 18.9±9.2 mL, respectively. When one fallopian tube was patent, the area under the curve (AUC) for distinguishing obstruction from patency of the other fallopian tube was 0.827, with a sensitivity of 79.8% and a specificity of 74.3% (cutoff value: 254.3 mmHg). Similarly, when one fallopian tube was nonpatent, the AUC was 0.866, with a sensitivity of 90.6% and a specificity of 78.3% (cutoff value: 401.3 mmHg). Conclusions Peak injection pressure during 4D-HyCoSy demonstrates promising diagnostic performance in evaluating fallopian tube patency in infertile patients.

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Section: Discussionmentioning

confidence: 99%

Evaluation of tubal patency based on peak injection pressure in four-dimensional hysterosalpingo-contrast sonography among infertile females: a preliminary study

Wang,

Chen,

et al. 2024

Quant Imaging Med Surg

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“…Therefore, additional evaluation or other diagnostic tests may be necessary in some cases to gain a more comprehensive understanding of tubal health. Despite its limitations, HSG remains an invaluable tool in the diagnostic process for individuals seeking answers regarding their fertility and offers a vital first step in identifying and addressing tubal-related issues [ 37 ].…”

Section: Reviewmentioning

confidence: 99%

Navigating Fertility Challenges: A Comprehensive Review of Microsurgery for Fallopian Tubal Re-canalization in the Era of In Vitro Fertilization (IVF)

Sethi,

Agrawal,

Dewani

et al. 2024

Cureus

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The journey of addressing fertility challenges, especially in the context of fallopian tubal issues, has witnessed remarkable advancements. This comprehensive review delves into microsurgery for fallopian tubal re-canalization within the era of in vitro fertilization (IVF). The review begins by providing the historical backdrop, tracing the evolution of this surgical technique, and highlighting the transformative impact of microsurgical methods and instrumentation on its precision and outcomes. Microsurgery for fallopian tubal re-canalization is characterized by a range of patient-specific considerations, diagnostic modalities, and factors influencing the choice between re-canalization and IVF. Microsurgical techniques are elaborated upon, showcasing the importance of laparoscopy and hysteroscopy, which not only diagnose but also treat tubal and uterine conditions. The review delves into the pivotal elements that steer the decision-making process, including patient preferences, medical necessity, ethical and religious considerations, financial constraints, and clinical evaluation. Furthermore, the intricate complications and risks associated with tubal re-canalization, both intraoperative and postoperative, are elucidated. Insights into recent advances in microsurgery, emerging research, and promising future directions set the stage for innovative and effective solutions. Recognizing the significance of patient counseling, shared decision-making, ethical considerations, and informed consent, the review underlines the critical role of healthcare providers in guiding individuals and couples through the complexities of fertility treatment choices. Finally, the conclusion synthesizes the key findings, implications for clinical practice, and future research directions, emphasizing the importance of tailored and patient-centered approaches to address fertility challenges in the modern era.

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“…In cases where abnormalities are detected, clinicians may recommend additional procedures such as HSG and contrast imaging studies to provide a more detailed assessment of tubal function. The insights gleaned from transvaginal sonography serve as a foundation for clinical decisions, ensuring that patients receive appropriate and timely interventions to address tubal-related fertility issues [50].…”

Section: Tubal Patency Evaluationmentioning

confidence: 99%

Role of Transvaginal Sonography in the Diagnosis of Female Infertility: A Comprehensive Review

Thaker,

Dhande,

Parihar

2023

Cureus

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Female infertility, a complex and emotionally challenging condition, impacts millions of women worldwide. Timely and accurate diagnosis is crucial for tailoring effective solutions to overcome fertility challenges. Transvaginal sonography, a real-time and non-invasive imaging modality, is pivotal in this diagnostic process. This review focuses on the structural abnormalities of the female reproductive system related to female infertility, particularly highlighting the capabilities of transvaginal sonography in assessing ovulatory disorders, structural anomalies, endometrial conditions, ovarian reserve, and other contributing factors. It is important to note that while transvaginal sonography excels in detecting structural abnormalities, it may not effectively identify lifestyle and hormonal changes. This limitation underscores the necessity for a comprehensive diagnostic approach that includes additional modalities to address the multifaceted nature of female infertility. Despite acknowledging the inherent limitations and operator dependence of transvaginal sonography, we emphasize its significance in guiding clinicians toward wellinformed decisions and personalized treatment plans. Looking forward, we anticipate the continual evolution of sonographic technology, offering enhanced diagnostic capabilities. The commitment to improving fertility outcomes for individuals and couples navigating the intricate path toward parenthood remains paramount. In conclusion, a holistic diagnostic approach incorporating various modalities is essential for a thorough understanding and effective management of female infertility.

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Evaluation of tubal patency by hysterosalpingo-contrast Sonography (HyCoSy): Controversies, dilemmas and considerations

Cited by 3 publications

References 57 publications

Evaluation of tubal patency based on peak injection pressure in four-dimensional hysterosalpingo-contrast sonography among infertile females: a preliminary study

Evaluation of tubal patency based on peak injection pressure in four-dimensional hysterosalpingo-contrast sonography among infertile females: a preliminary study

Navigating Fertility Challenges: A Comprehensive Review of Microsurgery for Fallopian Tubal Re-canalization in the Era of In Vitro Fertilization (IVF)

Role of Transvaginal Sonography in the Diagnosis of Female Infertility: A Comprehensive Review

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