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

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

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


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

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

University hospital and teaching hospital.

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.

Tubal patency testing by HyFoSy versus serial HSG.

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

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.

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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