[Cost effective media in vaginal ultrasound uterus and fallopian tube diagnosis]

The recent development of hysterocontrastsonography (HyCoSy) for assessing tubal patency may provide an alternative to current methods, which are either invasive (laparoscopy and dye) or involve exposure to radiation and require a radiology department (hysterosalpingography).

Following the introduction of an intrauterine balloon catheter, the contrast agent (Echovist) is slowly injected into the cavity and tracked using ultrasound as it passes through the tubes. The technique is well tolerated as an outpatient method, and takes about 15 to 20 minutes to perform.

In a clinical trial with infertile women we compared the results of HyCoSy to laparoscopy and dye. In 90 out of 108 tubes investigated the results agreed-equivalent to a sensitivity of 88% and a specificity of 82%. Three false negative findings on the one hand and 15 false positive findings on the other represent a negative predictive value of 96% and a positive predictive value of 58%. In approximately 50% of patients, this outpatient procedure caused little or no pain, and in 40%, moderate pain. Only a small part of the investigated group (8%) complained about serious discomfort; in two cases (3%) the procedure was discontinued because of pain.

HyCoSy is a reliable and simple method to provide preliminary information about tubal patency. It may be carried out at an early stage of the algorithm to investigate the infertile couple, and may so lead to more rapid and efficient treatment.