OP11.06: The role of Contrast‐HyCoSy for tubal patency in an infertility program

Abstract

Objectives: To compare the efficacy of multi-step hysterosalpingo contrast sonographic (HyCoSy)-based triage for the assessment of tubal patency with X-ray hysterosalpingography (HSG) and laparoscopy (LPS) in an outpatient office infertility program. Methods: Infertile patients are routinely examined by HyCoSy during the proliferative phase to asses tubal patency. The first step was based on a 2D-HyCoSy using saline mixed with air. If tubal patency was doubtful, patients underwent a 2D-HyCoSy using Sonovue (Bracco Diagnostics, Inc.) as contrast media and Contrast-Tuned Imaging. In doubtful cases this second procedure was performed during the same examination with the same catheter (8Fr–Nelaton). These cases underwent as confirmative test either HSG or LPS. Sensitivity and specificity of this multi-step HyCoSy compared to HSG and LPS was calculated by statistical analysis. Results: In 68 patients tubal patency was assessed at saline–air HyCoSy (69%). We report the results of this multi-step HyCoSy in the remaining 30 doubtful cases (59 tubes) compared to HSG (34 tubes)–LPS (25 tubes) (Table). The six discordant occluded tubes proved patent at LPS, similarly the one discordant patent at HyCoSy was found occluded at LPS. Therefore sensitivity and specificity of contrast-HyCoSy when compared to HSG were both 100%. Sensitivity and specificity at LPS were 87% and 60%, respectively.