HyCoSy (hystero-salpingo contrast sonography) is an ultrasound technique developed to assess whether the fallopian tubes are open or blocked.
Some cases of infertility cases are due to the woman’s tubes being blocked.
The fallopian tubes play a crucial role in reproduction. They serve as the meeting point for the egg, produced by the ovary, and the sperm, which is necessary for pregnancy to occur.
Following fertilisation within the tube, the embryo then needs to travel to the uterine cavity for implantation. If the tube is blocked, it may prevent the egg and sperm from uniting, leading to infertility issues.
During a HyCoSy procedure, we evaluate the condition of your fallopian tubes by injecting a small amount of sterile saline water mixed with air bubbles into your uterus. We will monitor the ultrasound screen to observe whether the air bubbles pass through the fallopian tubes. If the bubbles successfully travel through the tubes, it indicates that they are open. In addition we will also see saline pooling in the pelvis providing more evidence that the tubes are not blocked.
As part of our test we also perform a Hysterosonogram. This allows us to evaluate the shape of the womb and exclude other factors that may be leading to reduced fertility such as scarring, polyps or fibroids.
Having a HyCoSy procedure has been shown to increase the rate of falling pregnant.
No one is entirely sure why tubal flushing increases your pregnancy odds. It is thought that the fallopian tubes are cleared and blockages removed.
Medical studies have shown an increase in the rate of falling pregnant following a HyCoSy procedure as detailed in the following medical journal articles:
- Liu Y, Zhang N, He Y, Shi J, Zhou M, Xu J, Liu H. Spontaneous conception outcome in infertile women after four-dimensional hysterosalpingo contrastsonography. BMC Pregnancy Childbirth. 2020 Oct 20;20(1):638. doi: 10.1186/s12884-020-03315-x.
- Chunyan G, Bin P, Ping Y, Yue Z, Yang X, Hongju T, Li S, Xi X. Assessment of the Influence on Spontaneous Pregnancy of Hysterosalpingo-Contrast Sonography. Biomed Res Int. 2018 Sep 20;2018:4901281. doi: 10.1155/2018/4901281.
- Wang R, van Welie N, van Rijswijk J, Johnson NP, Norman RJ, Dreyer K, Mijatovic V, Mol BW. Effectiveness on fertility outcome of tubal flushing with
different contrast media: systematic review and network meta-analysis. Ultrasound Obstet Gynecol. 2019 Aug;54(2):172-181. doi: 10.1002/uog.20238.
Most women experience only mild discomfort. Others may experience period-type cramping during the procedure. This can be minimised by taking two tablets of an anti-inflammatory medication such as Nurofen, Brufen or Naprogesic one hour before the procedure. Women who are unable to take anti-inflammatory medications may substitute by taking Panadol.
Some women feel a bit faint after the procedure, but recover well with rest.
To ensure safety, it is essential the HyCoSy procedure is not performed if you are pregnant.
The ideal time to plan for the test is during the first half of your cycle. Specifically between day 5 and day 10 of your menstrual cycle, counting from the first day of the beginning of your period.
The test may be scheduled at anytime if you have no period or an irregular cycle.
On the day of the procedure, prior to starting your HyCoSy, our team will offer you a urine pregnancy test. Once we have determined you are not pregnant, we can then undertake the HyCoSy.
It is crucial to avoid the test if there is any possibility of an acute pelvic infection. It is important to discuss with your referring doctor whether you may be at risk of infection, and, if so, obtain a prescription for antibiotics to be taken a few hours prior to the procedure.
You do not need to have a full bladder.
You will be positioned on the bed with your feet comfortably resting.
A trans-vaginal ultrasound is then performed, where we will assess the shape and appearance of your uterus, the endometrium (lining of the womb), and the ovaries.
Once the initial assessment has been performed we are ready to continue with the HyCoSy.
The vagina is cleansed with antiseptic. A speculum is inserted into the vagina, similar to a pap smear. Then a very thin (2mm) tube, or catheter, is passed through the cervix into the uterus. A small balloon on the catheter is inflated to keep the catheter in place. The speculum is then removed and replaced by the trans-vaginal ultrasound probe.
At the end of the procedure we discuss the results directly with you. A detailed report is also sent to your doctor.
Although most women are able to drive themselves home following the HyCoSy procedure, it is advisable to have someone available to assist you as faintness, cramping or pain may occur . Mild cramping and watery discharge from the vagina are normal after the procedure and may last for up to 24 hours. In some cases, light bleeding or spotting may also occur for 3-4 days, which should be controlled by wearing a panty liner or pad. Please do not use a tampon (to minimise the risk of infection).
In the days following the procedure if you experience foul-smelling discharge or a fever greater than 38 degrees C, this could be a sign of infection. Please contact All Clear Fertility Imaging or your referring doctor.