Hysterosalpingo-Contrast-Sonography (HyCoSy) and Colour Doppler for the Evaluation of Tubal Patency as an Outpatient procedure in Infertility Clinic
Abstract
Objective: This study was aimed to analyze the applicability of Hysterosalpingo-contrast- sonography (HyCoSy) and colour Doppler in the evaluation of tubal patency in infertile women, as an outpatient procedure in an infertility clinic.
Method: 50 women suffering from primary and secondary infertility were evaluated for tubal patency within one year from January 2012, with HyCoSy and colour Doppler. A combination of 100ml (200mg) injection ciprofloxacin, 100mg hydrocortisone and 4cc of air is used as the contrast medium. Using a No. 8 pediatric Foleys catheter this contrast medium is injected into the uterine cavity. This test was done in early follicular phase, between 8th to 10th days of period. In HyCoSy tubal patency was confirmed by visualizing the spill of contrast media from the fimbrial end of fallopian tubes, known as water fall sign and mosaic pattern in colour Doppler, during the injection of contrast media in to the tube. Post procedure collection of fluid in cul- de- sac and free floating fimbria of the tube are other supportive signs.
Results: Out of 50 women studied bilateral tubal patency was confirmed in 42 giving an incidence of 84%. Bilateral tubal block was seen in 2 women (4%) and 6 had unilateral tubal block giving an incidence of 12%. There were no major side effects. 12 women (24%) complained of lower abdominalpain, 2 of them which lasted up to 12 hours and 2 (4%) had vaginal spotting lasting up to one day. Procedure was not completed in three women because two had syncope after inflating the Foleys bulb and in one it was not possible to introduce the catheter. The failure rate was 5.6% (3/53). Successful completion of HyCoSy was possible in 94.3% of subjects without any major complications.
Conclusion: HyCoSy offers certain advantages over hysterosalpingography (HSG), such as the elimination of iodinated contrast and exposure to ionizing radiations. TVS provides complete examination of the entire pelvis thus delineating uterine and ovarian pathology. HyCoSy is more convenient, less expensive and non invasive procedure to evaluate tubal function. In conclusion HyCoSy is the method of choice in assessing tubal patency as an outpatient procedure in an infertility clinic
When publishing with Kerala Medicial Journal (KMJ), authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal. Work includes the material submitted for publication and any other related material submitted to KMJ. In the event that KMJ does not publish said work, the author(s) will be so notified and all rights assigned hereunder will revert to the author(s).
The assignment of rights to KMJ includes but is not expressly limited to rights to edit, publish, reproduce, distribute copies, include in indexes or search databases in print, electronic, or other media, whether or not in use at the time of execution of this agreement.
Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
The author(s) hereby represents and warrants that they are sole author(s) of the work, that all authors have participated in and agree with the content and conclusions of the work, that the work is original, and does not infringe upon any copyright, propriety, or personal right of any third party, and that no part of it nor any work based on substantially similar data has been submitted to another publication.
