Tanaka Keisuke, Chua Jackie, Cincotta Robert, Ballard Emma L, Duncombe Gregory
Department of Obstetrics and Gynaecology, Gold Coast University Hospital, Southport, Australia.
Queensland Ultrasound for Women, Spring Hill, Australia.
Aust N Z J Obstet Gynaecol. 2018 Feb;58(1):114-118. doi: 10.1111/ajo.12716. Epub 2017 Sep 26.
Fallopian tube patency testing is an essential part of infertility evaluation. Hysterosalpingo-contrast sonography (HyCoSy) has been described as reliable, well tolerated and safe compared to other modalities such as laparoscopy and a dye test or hysterosalpingography. Limited availability of the previously used contrast has led to the introduction of a foam contrast agent as an alternative.
To assess the tolerability, safety and occurrence of pregnancy post-procedure of hysterosalpingo-foam sonography (HyFoSy).
A retrospective cohort study of women who had a HyFoSy at Queensland Ultrasound for Women from March 2013 to February 2015. A questionnaire was sent to their referring doctor to identify any complications or subsequent pregnancies with or without artificial reproductive technology (ART) within six months of the HyFoSy.
Of 200 women, four cases were abandoned due to difficulty introducing the intracervical catheter, severe discomfort or a vasovagal episode. Response from referring doctors for 155 women reported no post-procedural complication. One hundred and eleven women were followed up for at least six months. Twenty-four out of 59 women (40.7%) who had ART and 24 out of 52 women (46.2%) who did not have ART conceived. Fifty percent of women who were nulligravida at the time of investigation, found to have at least one patent fallopian tube, whose partner had a normal semen analysis, spontaneously conceived within the time of follow up.
HyFoSy is well tolerated and safe. A preponderance of pregnancies in the first month after HyFoSy suggests that a therapeutic effect may exist.
输卵管通畅性检测是不孕症评估的重要组成部分。与腹腔镜检查、染料试验或子宫输卵管造影等其他检查方式相比,子宫输卵管超声造影(HyCoSy)已被描述为可靠、耐受性良好且安全。先前使用的造影剂供应有限,导致引入了泡沫造影剂作为替代。
评估子宫输卵管泡沫超声造影(HyFoSy)的耐受性、安全性及术后妊娠发生率。
对2013年3月至2015年2月在昆士兰妇女超声中心接受HyFoSy检查的女性进行回顾性队列研究。向她们的转诊医生发送问卷,以确定在HyFoSy检查后六个月内有无任何并发症或后续妊娠情况(无论是否采用辅助生殖技术(ART))。
200名女性中,有4例因宫颈内导管置入困难、严重不适或血管迷走神经反应而放弃检查。155名女性的转诊医生回复称无术后并发症。111名女性接受了至少六个月的随访。接受ART的59名女性中有24名(40.7%)妊娠,未接受ART的52名女性中有24名(46.2%)妊娠。在检查时未孕的女性中,发现至少一侧输卵管通畅且其伴侣精液分析正常的女性,有50%在随访期间自然受孕。
HyFoSy耐受性良好且安全。HyFoSy后第一个月妊娠率较高,提示可能存在治疗效果。