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What are the common methods to evaluate the Fallopian tubes?

The most common methods for investigating tubal patency include X-ray hysterosalpingography (HSG), and hysterosalpingo-contrast sonography (HyCoSy). HSG is the traditional method. HyCoSy and, later on, HyFoSy (using foam gel as contrast) were introduced as an alternative to HSG, thereby avoiding exposure to the risks of iodine allergy or X-Ray radiation. These are ultrasound-based techniques that allow to detect abnormalities of fallopian tubes in real-time, and safer for the patient.

What are the common indications for having HyFoSy?

  • Investigation of sub-fertility once the male factor is excluded.

When is the best time to have HyFoSy done?

It is best done between day 5 – Day 11 of the menstrual cycle, taking the first day of your period as day 1.

How is HyFoSy done?

It usually takes about 10-15 minutes to do the procedure.
A transvaginal scan is done to assess the pelvic anatomy. Following this, a speculum is placed in the vagina and the cervix is cleaned. A fine sterile plastic catheter is then placed in the uterine cavity. Again, a transvaginal scan is performed as the contrast (foam gel) is injected through the catheter. The gel allows the visualization of the tube and the spillage around the ovaries. When the spilling is seen easily on both sides, the fallopian tubes are considered to be patent.
Usually, the procedure is well tolerated and no painkillers are necessary.

What are the advantages of having HyFoSy?

  • There is no radiation or iodinated contrast involved.
  • HyFoSy is less uncomfortable than HSG as the fluid injected produces less irritation than the one used in HSG.
  • Ultrasound examination allows assessment of other pelvic structures.

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