Hysterosalpingo foam sonography A less painful procedure for tubal patency testing during fertility workup compared to serial hysterosalpingography A randomized controlled trial

Capsule:
Hysterosalpingo-foam sonography (HyFoSy) is a less painful office procedure for tubal patency testing during the fertility work-up compared to hysterosalpingography.

Authors:
Kim Dreyer, M.D., Renee Out, M.D., Peter G. Hompes, M.D., Ph.D., Velja Mijatovic, M.D., Ph.D.

Volume 102, Issue 3, Pages 821-825

Abstract:

Objective:
To determine whether hysterosalpingo-foam sonography (HyFoSy) is a less painful first line tubal patency test than serial hysterosalpingography (HSG).

Design:
A two-center, prospective, open-label, randomized, controlled trial.

Setting:
University hospital and teaching hospital.

Patient(s):
40 subfertile women, ages 18 to 41 years, with an indication for tubal patency testing as part of the fertility workup according to the Dutch Nederlandse Vereniging voor Obsteterie & Gynaecologie-guidelines.

Intervention(s):
Tubal patency testing by HyFoSy versus serial HSG.

Main Outcome Measure(s):
Visual Analogue Scale (VAS) pain scores during tubal patency testing.

Result(s):
The median VAS score for pain perception during the HyFoSy procedure was 1.7 cm (interquartile range: 2.1) compared with 3.7 cm (interquartile range: 4.2) during HSG. The HyFoSy procedure also had a statistically significantly shorter procedure time compared with HSG, with a median of 5.0 minutes (interquartile range: 3.0) for HyFoSy versus 12.5 minutes (interquartile range: 16.0) for HSG.

Conclusion(s):
The HyFoSy procedure is a less painful and less time-consuming tubal patency test compared with HSG.

Clinical Trial Registration Number:
Netherlands National Trial Register NTR3457.

  • Reshef Tal

    Encouraging data from Netherlands about a new and promising technique for tubal patency evaluation which appears to have many advantages over HSG: it can be performed by a single operator in an outpatient setting, avoids radiation exposure, is less time-consuming and less painful. Given the very high costs involved in infertility evaluation and treatment in the US, it would be interesting to conduct a cost-effective analysis of such technology in the US healthcare system.

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