A HyCoSy fertility scan is a short procedure to detect any damage or blockage in the fallopian tubes. Tubal Patency Test or a Dye Test are other names for the procedure.

It can substitute a HSG (Hysterosalpingography) or Laparoscopy and Dye, without the need to perform X-ray.

The ultrasound contrast medium is injected into the fallopian tubes by means of a small thin catheter inserted into the uterus.

The fluid is traceable and can be monitored by ultrasound. This reveals any blockages or abnormalities.

Indications for a HyCoSy (fallopian tube patency test)

If you are considering this procedure we advise to contact us and arrange an appointment while you are on the 1st or 2nd day of your period. The span between 6 to 10 days of your cycle is considered the optimal time to perform the HyCoSy.

HyCoSy Procedure

Our HyCoSy is performed with the use of 3D ultrasound, resulting in a noticeably higher quality of scans than with 2D ultrasonography.

A contrast medium is introduced into the uterus  through the cervical canal, through the fallopian tubes and into the peritoneal cavity.

The contrast medium movement is monitored through a transvaginal (internal) scan. This procedure reveals any blockages in the Fallopian Tubes capable of preventing a safe passage of an egg during the ovulation. The procedure should be scheduled after menstruation in the first half of the cycle, in the period between days 5 and 12.

Our own staff performs such highly-skilled treatments as HyCoSys for our patients. Our experts also carry out the treatment for patients referred to us by other fertility centres, fertility specialists, GPs and gynaecologists or for those patients who come to us after consulting with our specialists. For example, in case of unexplained infertility at a young age or if there is a concern that an infection such as chlamydia could have damaged the Fallopian Tubes.

A catheter is passed into the uterus (womb) through the vagina and the cervix during the procedure. A small balloon prevents the catheter from moving inside the uterine cavity while the contrast medium is introduced through the catheter. At this point the patient may feel some discomfort similar to uterine cramps during her period. An ultrasound scan allows the doctor to monitor the whole procedure. On the scan the contrast medium passing through your fallopian tubes is clearly visible.

What is the timing of the HyCoSy test?

Our HyCoSy (fallopian tube patency test) takes approximately 30 minutes with no need of anesthetic.

Sexual life and HyCoSy treatment

We recommend avoiding intercourse from the first day of your last menstrual period until after the HyCoSy (fallopian tube patency test). After the procedure you can resume your usual daily activities including protected or unprotected sexual intercourse.

HyCoSy & Chlamydia

Your consultant may suggest a high vaginal swab and chlamydia screen before the HyCoSy (fallopian tube patency test). This will exclude infection prior to the HyCoSy test, or you may be prescribed a course of antibiotics.

Painkillers & Antibiotics

Two pills of Paracetamol or any other common pain medication is advisable 1–2 hours before the test. For more information on the use of painkillers for any reason, including any medical condition that you may have please contact our experts.

Follow-up treatment after HyCoSy (fallopian tube patency test)

After the HyCoSy you will discuss the results with your doctor and receive a written report by post. The results indicate where the contrast medium flowed without impedance and also highlight any abnormality. In such cases laparoscopy and/or hysteroscopy may be recommended to better understand the situation. You will discuss this in greater detail in a scheduled meeting with your consultant.

After the treatment, you will need to take a 5-day course of antibiotics to reduce the risk of infection. You will receive the prescription on the day of the procedure.

Sonohysterogram or Hysterosonogram

What is a sonohysterogram?

Sonohysterogram / saline ultrasound /saline sonogram / saline infusion sonogram are other names of hysterosonogram commonly known as HSN. It is an ultrasound procedure with minimum invasion that helps detect any abnormalities inside the uterus that may be detrimental for pregnancy.

Before the patient proceeds with an IVF cycle it is necessary to evaluate the uterine cavity with a sonohysterogram or other method. It is a low-risk procedure that does not involve radiation. Sonohysterogram that introduces sterile fluid inside the uterus is better at detecting abnormalities on the inside walls of the uterus in comparison with a regular ultrasound. During this procedure, the uterine walls are separated and any previously hidden abnormalities become easily identifiable.

Here is an example, which explains why we recommend a hysterosonogram. Imagine your uterus as a collapsed balloon. If this collapsed balloon has a small growth or bump on its wall it may be difficult to see it since the walls are very close together. But if this balloon is inflated the small growth is likely to hang away from the wall thus becoming detectable.

A test called a hysteroscopy is a traditional way to look for abnormalities inside the uterus and it has been the best for a long time. It involves an out-patient surgery with a kind of telescope to see inside the uterus. Recently, due to the advances in sonohysterogram techniques this procedure has replaced hysteroscopy and has become the first choice to look for abnormalities in the uterus. Sonohysterogram is less invasive in comparison to hysteroscopy, and it is nearly as effective at detecting abnormalities.

What kind of issues can a hysterosonogram help discover?

This procedure is often recommended for women who cannot conceive or for those having recurrent miscarriages. In some cases, women experiencing abnormal vaginal bleeding may opt for a hysterosonogram. This procedure results in a very detailed view of the inside walls of the uterus and allows the experts to identify many types of abnormalities that can stand in the way of a successful pregnancy. Experience shows that it can detect over 90% of abnormalities inside the uterus.

Some of these include:

• Polyps
• Fibroids
• Uterine septum
• Bicornuate Uterus
• Scar tissue

What does this procedure involve?

The sonohysterogram procedure is very simple and usually does not exceed 5 minutes. You will need to contact us on the first day of your period to schedule a sonohysterogram. Your appointment will take place at some point after your period bleeding is over, but before the expected date of the ovulation. This is needed to ensure that the lining inside the uterus is at its thinnest. It is important as this way your doctor will have less difficulty detecting any defects that may be present. The procedure takes place in the office. With the use of a speculum a thin, soft and bending plastic catheter will be inserted into the lower part of the uterine cavity through the vagina and cervix. After that the speculum is carefully removed so as not to disturb the catheter. Then, a vaginal ultrasound probe is inserted into the vagina. A small amount of saline (sterile salt water) is injected into the uterine cavity via the catheter in order to separate the walls.

• The ultrasound probe may be rotated to visualize the long axis or the transverse axis of the uterus during the procedure. The uterine cavity appears long and oval in the long axis.
• The uterine cavity looks triangular in the transverse view.
• The saline looks dark black on the ultrasound scans. Any abnormal growth inside the cavity will appear as ovoid, grey to white formation protruding into the cavity. A cavity that is split will show the black saline separated into two areas.

In rare cases, an insignificant amount of the saline may leak out of the vagina after the procedure. Some bleeding or spotting is also possible. We recommend our patients to wear a light pad or tampon for the rest of the day.

What is essential to do before taking a hysterosonogram?

In some cases, women might experience slight cramping during or after the procedure. Patients may take 1–2 pills of ibuprofen 1–2 hours prior to the procedure and one more time 3–4 hours after the procedure the cramping persists, however it is unlikely.

What is essential to do after a sonohysterogram?

You will see the sonohysterogram on a monitor during the procedure. After it is finished, you will discuss the results with the doctor. You do not need to worry if any abnormalities are present inside your uterus. Almost all the conditions in such cases are easily treated outpatiently and with minimum invasion (usually via a hysteroscopy).