First experiences with hysterosalpingo-foam sonography (HyFoSy) for office tubal patency testing

BACKGROUND: This study was conducted to describe the first experiences with hysterosalpingo-foam sonography (HyFoSy) as a first step routine office procedure for tubal patency testing. METHODS: A prospective observational cohort study was started in a university affiliated teaching hospital. In 2010, 73 patients with subfertility and a low risk of tubal pathology were examined. A non-toxic foam containing hydroxymethylcellulose and glycerol was applicated through a cervical applicator for contrast sonography (HyFoSy). Tubal patency was determined by transvaginal ultrasonographic demonstration of echogenic dispersion of foam in the Fallopian tube and/or the peritoneal cavity. Only in case patency could not be demonstrated, a hysterosalpingography (HSG) was performed as a control. RESULTS: In 67 out of 73 (92) patients, a successful procedure was performed. In 57 out of 73 (78) cases, there was no further need for a HSG. In five patients (5/73; 7) tubal occlusion was confirmed by HSG and in five patients (5/73; 7) there was discordance between HyFoSy and HSG. Of 73 patients, 14 (19) conceived within a median of 3 months after the procedure. CONCLUSIONS: HyFoSy is a successful procedure to demonstrate tubal patency as a first step office procedure.