OUTPATIENT HYSTERO-CONTRAST SONOGRAPHY (HY-CO-SY) AS A NEW APPROACH TO EVALUATE PATENCY OF THE FALLOPIAN-TUBES

For the diagnostic evaluation of infertility it is crucial to obtain information on potential abnormalities of the uterus or the fallopian tubes. At present, the following diagnostic methods are available: CO2-pertubation, hysteroscopy, hysterosalpingography (HSG) and chromolaparoscopy (CLP). For the latter procedure, general anaesthesia is required. In a clinical trial 103 patients from our infertility clinic were examined for fallopian tube patency using the contrast agent SH U 454 (Echovist(R)). The new technique hystero-contrast sonography (Hy-Co-Sy) was carried out in an outpatient set ting without requiring general anaesthesia. Informed consent was obtain from all patients. A Foley catheter was inserted into the uterine cavity, the balloon was inflated and the contrast medium injected. Distribution of the contrast agent as well as the uterine cavity, the fallopian tubes as well as in the pouch of Douglas was then observed by sonography. In addition to Hy-Co-Sy, 58 patients underwent HSG or CLP. Hy-Co-Sy findings could confirmed by HSG and CLP in 90.6 % and 91.6 %, respectively. Patients were asked to describe their discomfort on a scale of one to hundred. The avarage time required for the assessment to tubal patency was 9 minutes. Within 12 months of the Hy-Co-Sy study, 23 out of 60 patients (38.3 %) became pregnant. Our study shows that Hy-Co-Sy is a valuable and reliable procedure to assess the uterine cavity and the fallopian tubes in patients undergoing treatment for infertility. The procedure can be performed safely in the office without the need for general anaesthesia. A major advantage of Hy-Co-Sy over HSG is the fact that it does not expose the patient to potentially hazardous radiation.