Medical examination of fallopian tube patency (HyCoSy)
In addition to testing a woman’s blood and a man’s sperm, an important screening for infertility is an examination of fallopian tube patency. Previously, this procedure could only be carried out with x-ray imaging (hysterosalpingography) and was quite painful, or by laparoscopy with chromopertubation. It is now possible to examine the fallopian tubes with a special contrast ultrasound method (Hysterosalpingo Contrast Sonography or HyCoSy) in our clinic.
During the first step of the procedure, a sugar-based contrast medium (hydroxyethyl cellulose and glycerin) is injected into the uterus with a delicate tube. This solution flows through the fallopian tubes and exits at the ovaries. This process is viewed with a vaginal ultrasound. Should the fallopian tube be patent, a white line appears on the screen, representing an open fallopian tube. In the second step the uterine cavity is filled with a saline solution. This makes it possible to observe small variations on the interior wall of the uterus, for example polyps or myomas, which could be possible barriers to the nidation of the embryo.
Step 1: Representation of the fallopian tube
Step 2: Representation of the uterine cavity
No anesthesia is needed during the short examination, and you can return to normal work right away. Occasionally, you may feel discomfort similar to menstrual cramps as well as a slight feeling of sickness during the examination. I conduct the HyCoSy in our clinic, between the 8th and 14th day in the first half of your menstrual cycle, as part of an overall infertility examination and evaluation, and advise about further procedures.
Such flushing of the fallopian tubes is not only a diagnostic measure, but also an opportunity to remove small adhesions in the fallopian tubes, and therefore improve their permeability. Studies indicate that the chance of getting pregnant increases, especially in the first few cycles after being performed.
Summary:
https://www.hindawi.com/journals/bmri/2018/4901281/
https://academic.oup.com/humrep/article/23/4/852/621027
https://ecerm.org/m/journal/view.php?doi=10.5653/cerm.2012.39.4.161