Hysterosalpingo‐foam sonography (HyFoSy): a new technique to visualize tubal patency

Emanuel, M.H.; Exalto, N.

doi:10.1002/uog.8912

Cited by 38 publications

(35 citation statements)

References 11 publications

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“…[25] Demonstration of the lumen of tubes requires visualization of movement of fluid using highly echogenic medium. [26] Hyperechogenic contrast medium enhances echo signals and allows detection of the flow, both by B mode and Doppler ultrasound.…”

Section: Hycosymentioning

confidence: 99%

Imaging techniques for assessment of tubal status

Panchal¹,

Nagori²

2014

J Hum Reprod Sci

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Fallopian tubes make a vital portal for transfer of gametes and embryo. Tubal factor is responsible for infertility in 25-35% of cases. Hysterosalpingography (HSG) has been used to evaluate the uterine cavity and the tubal status since decades. It uses iodinated contrast and X-rays and is painful and inconvenient for patient. Laparoscopy is considered to be the gold standard for tubal evaluation, but is an operative procedure and needs anesthesia. Though ultrasound is a modality of choice for assessment of uterus and ovaries, it does not allow assessment of the fallopian tube unless there is any fluid surrounding it or inside the lumen. This fluid interface can be created artificially by introducing saline in the uterine cavity and fallopian tubes and scanning simultaneously. The procedure is named Saline infusion HSG. Saline infusion sonohysterosalpingography (SIS) can be done with B mode US and Doppler. SIS can demonstrate a patent tube but if blocked, the site of block cannot be demonstrated. Ultrasound contrast agents can be used for tubal assessment using contrast mode on the scanners. This procedure is known as hystero-contrast sonography (HyCoSy). This actually shows the passage of hyperechoic contrast agent through tubal lumen and delineates it and locates the site of block. Using the volume ultrasound may even make the demonstration of tubal status and fimbriae better. Results of HyCoSy have been found to correlate well with laparoscopic findings, which are a gold standard. It is recommended by National Institute for Health and Clinical Excellence as a primary investigation for tubal assessment in patients without any positive history of tubal damage and also can replace a second look laparoscopy.

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Section: Hycosymentioning

confidence: 99%

Imaging techniques for assessment of tubal status

Panchal¹,

Nagori²

2014

J Hum Reprod Sci

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“…The latter are ineffective and unnecessary, and only carry an unnecessary risk of cardiac complications and allergic reactions, respectively (Rijksen and Spaans, 2009). The safety profile of GIS and HyFoSy subsequently improved by omitting lidocaine and chorhexidine in the CE-marked gel (Emanuel and Exalto, 2011;Emanuel et al, 2012;Van den Bosch et al, 2011b;Van Schoubroeck et al, 2013). After more than 60,000 procedures with the gel, no allergic reactions or infections have been reported.…”

Section: Uterine Cavity Distensionmentioning

confidence: 89%

“…A combination of air and saline has been used as an alternative (Spalding et al, 1997). The development of HyFoSy with foam serves as an appropriate alternative for HyCoSy with Echovist (Bayer Schering Pharma AG) or saline (Emanuel and Exalto, 2011;Emanuel et al, 2012;Van Schoubroeck et al, 2013). HyFoSy with the foam also enables verification of correct placement of implants for sterilization like Essure (Bayer Healthcare AG, Leverkusen, Germany).…”

Section: Tubal Patency Testingmentioning

confidence: 99%

“…ExEm-foam (GynaecologIQ/GISKIT BV, Delft, the Netherlands) is used for hysterosalpingo-foam sonography (HyFoSy) as an alternative to hysterosalpingo-contrast sonography (HyCoSy) and hysterosalpingography (HSG) (Emanuel and Exalto, 2011;Emanuel et al, 2012;Van Schoubroeck et al, 2013). ExEm-foam (GynaecologIQ/GISKIT BV) can be created by diluting the gel in purified water.…”

Section: Introductionmentioning

confidence: 99%

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Safety aspects and side-effects of ExEm-gel and foam for uterine cavity distension and tubal patency testing

Exalto

Stassen

Emanuel

2014

Reproductive BioMedicine Online

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“…In 2007, a non-embryo-toxic gel known as ExEm ® gel (GynaecologIQ) containing hydroxyethylcellulose and glycerol was introduced 10. The gel is diluted in water, and foam is mechanically created when this solution is pushed through narrow openings in syringes and tubes.…”

Section: Introductionmentioning

confidence: 99%

Hysterosalpingo-foam sonography: patient selection and perspectives

Rajesh

Lim

2016

IJWH

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We present an overview of the common types of tubal patency tests, with a focus on hysterosalpingo-foam sonography (HyFoSy). Current evidence suggests that HyFoSy is an accurate alternative to X-ray hysterosalpingography (HSG) for outpatient tubal evaluation in women who are at low risk for tubal disease. It may be superior to saline hysterosalpingo-contrast sonography (HyCoSy) in excluding tubal occlusion. A hyperechogenic medium may enhance contrast visualization and enable clearer delineation of tubal anatomy. This may enhance confidence in the diagnosis of tubal patency, reduce false occlusion results, and improve the diagnostic yield of the test. It would be reasonable to deduce that HyFoSy would have similar performance characteristics as HyCoSy with other positive contrast agents. The available evidence supports the accuracy of HyFoSy compared to other forms of tubal investigation. We suggest a decision-making pathway based on the most current professional recommendations and available evidence. However, in this article, we do not provide a definitive exposition of the methods used for investigating tubal patency. Rather, we explore the contexts in which the various investigations are most and least suitable, and identify their strengths and limitations. Finally, we also discuss challenges encountered when performing tubal contrast sonography in clinical practice, including the problem of false occlusion results.

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Hysterosalpingo‐foam sonography (HyFoSy): a new technique to visualize tubal patency

Cited by 38 publications

References 11 publications

Imaging techniques for assessment of tubal status

Imaging techniques for assessment of tubal status

Safety aspects and side-effects of ExEm-gel and foam for uterine cavity distension and tubal patency testing

Hysterosalpingo-foam sonography: patient selection and perspectives

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