Abstract
Tubal pathology is a significant contributor to subfertility, and therefore, assessment of the fallopian tubes forms an important and integral part of the fertility workup. An ideal method of tubal assessment should be sensitive and specific, be relatively safe, widely available and inexpensive. Laparoscopy and dye testing is the gold standard method of tubal assessment. However, this is associated with operative risks as well as financial implications. Hysterosalpingography was classically the first-line investigation; however, this too has its associated risks such as exposure to radiation. More recently, HyCoSy, which involves ultrasonographic tubal assessment using contrast media, has become more widespread. This involves a transvaginal scan, injection of contrast media through the cervix and observation of bilateral spill from the fimbrial ends of the fallopian tubes. Some investigators have used air as an inexpensive alternative to contrast media. The use of colour flow Doppler, which demonstrates flow of medium through the fallopian tube (as oppose to simply detecting spill from the fimbrial ends), has also been described. In this chapter, we aim to outline the assessment of tubal patency using ultrasound examination.
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References
Steinkeler JA, Woodfield CA, Lazarus E, Hillstrom MM. Female infertility: a systematic approach to radiologic imaging and diagnosis. Radiographics. 2009;29:1353–70.
Lim CP, Hasafa Z, Bhattacharya S, Maheswari A. Should a hysterosalpingogram be a first-line investigation to diagnose female tubal subfertility in the modern subfertility workup? Hum Reprod. 2011;26(5):967–71.
Watrelot A, Hamilton J, Grudzinskas JG. Advances in the assessment of the uterus and fallopian tube function. Best Pract Res Clin Obstet Gynaecol. 2003;17(2):187–209.
Lanzani C, Savasi V, Leone FP, Ratti M, Ferrazzi E. Two-dimensional HyCoSy with contrast tuned imaging technology and a second-generation contrast media for the assessment of tubal patency in an infertility program. Fertil Steril. 2009;92:1158–61.
Coppus SFPJ, Opmeer BC, Logan S, Van der Veen F, Bhattacharya S, Mol BWJ. The predictive value of medical history taking and Chlamydia IgG ELISA antibody testing (CAT) in the selection of subfertile women for diagnostic laparoscopy: a clinical prediction model approach. Hum Reprod. 2007;22:1353–8.
Swart P, et al. The accuracy of hysterosalpingography in the diagnosis of tubal pathology: a meta-analysis. Fertil Steril. 1995;64(3):486–91.
den Hartog JE, Lardenoije CM, Severens JL, Land JA, Evers JL, Kessels AG. Screening strategies for tubal factor subfertility. Hum Reprod. 2008;23:1840–8.
National Collaboratry Centre for Women’s and Children’s Health. Fertility: Assessment and Treatment for People with Fertility Problems. Commissioned by the National Institute for Clinical Excellence (NICE). London: RCOG Press 2004. ISBN 1-900364-97-2.
Broeze KA, Opmeer BC, Van Geloven N, Coppus SFPJ, Collins JA, den Hartog JE, et al. Are patient characteristics associated with the accuracy of hysterosalpingography in diagnosing tubal pathology? An individual patient data meta-analysis. Hum Reprod. 2011;17:293–300.
Spring DB, et al. Potential therapeutic effects of contrast materials in hysterosalpingography: a prospective randomised controlled trial. Radiology. 2000;214:53–7.
Hart D, Hillier MC, Wall BF. HPA-RPD-029-doses to patients from radiographic and fluoroscopic X-ray imaging procedures in the UK – 2005. Review. 2009;2010:95.
Tur-Kaspa I, Seidman DS, Soriano D, Greenberg I, Dor J, Bider D. Hysterosalpingography with a balloon catheter versus a metal cannula: a prospective, randomized, blinded comparative study. Hum Reprod. 1998;13:75–7.
Nanini R, Chelo E, Branconi F, Tantini C, Scarselli GF. Dynamic echohysteroscopy: a new diagnostic technique in the study of female infertility. Acta Eur Fertil. 1981;12:165–71.
Campbell S, Bourne T, Tan S, Collins W. Hysterosalpingo-contrast-sonography (HyCoSy) and its future role within the investigation of infertility in Europe. Ultrasound Obstet Gynecol. 1994;4:245–53.
Spieldoch RL, Winter TC, Schouweiler C, Ansay S, Evans MD, Lindheim SR. Optimal catheter placement during sonohysterography: a randomized controlled trial comparing cervical to uterine placement. Obstet Gynecol. 2008;111:15–21.
Ayida G, Chamberlain P, Barlow D, Koninckx P, Golding S, Kennedy S. Is routine diagnostic laparoscopy for infertility still justified? A pilot-study assessing the use of hysterosalpingo-contrast sonography and magnetic resonance imaging. Hum Reprod. 1997;12(7):1436–9.
Tanawattanacharoen S, Suwajanakorn S, Uerpairojkit B, Boonkasemsanti W, Virutamesan P. Transvaginal hysterosalpingo-contrast sonography (HyCoSy) compared with chromolaparoscopy. J Obstet Gynaecol Res. 2000;26:71–5.
Exacoustos C, Di Giovanni A, Szabolcs B, Binder-Reisinger H, Gabardi C, Arduini D. Automated sonographic tubal patency evaluation with three-dimensional coded contrast imaging (CCI) during hysterosalpingo-contrast sonography (HyCoSy). Ultrasound Obstet Gynecol. 2009;34:609–12.
Zhou L, Zhang X, Chen X, Liao L, Pan R, Zhou N, Di N. Value of three-dimensional hysterosalpingo-contrast sonography with SonoVue in the assessment of tubal patency. Ultrasound Obstet Gynecol. 2012;40(1):93–8.
Kalogirou D, Antoniou G, Botsis G, Kassanos D, Vitoratos N, Zioris C. Is colour Doppler necessary in the evaluation of tubal patency by hystero-contrast-sonography. Clin Exp Obstet Gynecol. 1997;24(2):101–3.
Sladkevicius P, Ojha K, Campbell S, Nargund G. Three-dimensional power Doppler imaging in the assessment of fallopian tube patency. Ultrasound Obstet Gynecol. 2000;16(7):644–7.
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Vinayagam, D., Ojha, K. (2014). Evaluation of Tubal Patency (HyCoSy, Doppler). In: Stadtmauer, L., Tur-Kaspa, I. (eds) Ultrasound Imaging in Reproductive Medicine. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-9182-8_14
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DOI: https://doi.org/10.1007/978-1-4614-9182-8_14
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