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J R Soc Med. 1999 December; 92(12): 628–631.
PMCID: PMC1297468

Hysterosalpingo contrast sonography as a screening test for tubal patency in infertile women.


The most informative method for assessing tubal patency in subfertile women is laparoscopy-and-dye. This investigation, however, puts a large burden on services and a screening test is needed that identifies a high likelihood of occlusion. In our infertility programme we introduced hysterosalpingo contrast sonography for this purpose, operated entirely by ultrasonographers. A series of audits indicated that this innovation speeded the process of investigation by several weeks and reduced the number of laparoscopy-and-dye procedures by 75%. The negative predictive value was 89% and the positive predictive value was 44%. The main limitation of the method was the long period required for training, in those without extensive experience of vaginal ultrasonography.

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Selected References

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  • Holz K, Becker R, Schürmann R. Ultrasound in the investigation of tubal patency. A meta-analysis of three comparative studies of Echovist-200 including 1007 women. Zentralbl Gynakol. 1997;119(8):366–373. [PubMed]
  • Tanawattanacharoen S, Suwajanakorn S, Uerpairojkit B, Wisawasukmongchol W, Boonkasemsanti W, Virutamasen P. Transvaginal hysterosalpingo-contrast sonography (HyCoSy) compared with chromolaparoscopy: a preliminary report. J Med Assoc Thai. 1998 Jul;81(7):520–526. [PubMed]
  • Kalogirou D, Antoniou G, Botsis D, Kassanos D, Vitoratos N, Zioris C. Is color Doppler necessary in the evaluation of tubal patency by hysterosalpingo-contrast sonography. Clin Exp Obstet Gynecol. 1997;24(2):101–103. [PubMed]
  • Campbell S, Bourne TH, Tan SL, Collins WP. Hysterosalpingo contrast sonography (HyCoSy) and its future role within the investigation of infertility in Europe. Ultrasound Obstet Gynecol. 1994 May 1;4(3):245–253. [PubMed]

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