Division of Obstetrics and Prenatal Medicine, Department of Obstetrics and Gynaecology, Erasmus MC, University Medical Centre, Rotterdam, Netherlands.
Division of Woman and Baby, Department of Gynaecology and Reproductive Medicine, University Medical Centre, Utrecht, Netherlands.
Biomed Res Int. 2019 Jul 8;2019:4827376. doi: 10.1155/2019/4827376. eCollection 2019.
Tubal patency testing is an essential part of female subfertility evaluation. Traditionally, hysterosalpingography (HSG) was the first step to evaluate tubal patency. However, during the past decade Hysterosalpingo-Contrast Sonography (HyCoSy) was introduced in order to avoid radiation exposure and Hysterosalpingo-Foam Sonography (HyFoSy) has been developed as a safe and less painful alternative.
The aim of this narrative review is to provide an overview of the currently available HyFoSy literature and related clinical aspects.
A literature search was conducted using PubMed and Embase from the introduction of HyFoSy to March 2019. Unfortunately, a meta-analysis was not possible due to a too small number of studies, being mutually incomparable for the various subjects of clinical aspects, even for the reliability as a test for tubal patency.
Nine small studies concluded that the accuracy and effectiveness as a test for tubal patency of 2D- and 3D-HyFoSy are comparable or even better than HSG or HyCoSy. With or without using Doppler techniques, 3D-HyFoSy does not seem to offer benefits above real-time 2D-HyFoSy. Five studies reported on pain and discomfort during HyFoSy, concluding that HyFoSy is a well-tolerated, less painful procedure compared to HSG, without a need for the use of analgesics. There are suggestions about an increased pregnancy rate in the first three cycles after the procedure but in no studies pregnancy outcome after HyFoSy was compared with other or no intervention.
HyFoSy is a promising and safe alternative for HSG with regard to accuracy and effectiveness. HyFoSy lacks radiation and iodine exposure and is a well-tolerated and less painful procedure than HSG, without the need for analgesics. However more research is needed to make clear statements regarding a therapeutic effect of HyFoSy.
输卵管通畅性测试是女性不孕评估的重要组成部分。传统上，子宫输卵管造影术（HSG）是评估输卵管通畅性的第一步。然而，在过去的十年中，引入了子宫输卵管超声造影术（HyCoSy）以避免辐射暴露，并且开发了子宫输卵管泡沫超声造影术（HyFoSy）作为一种安全且疼痛较轻的替代方法。
本叙述性综述的目的是提供当前可用的 HyFoSy 文献和相关临床方面的概述。
使用 PubMed 和 Embase 从 HyFoSy 的引入到 2019 年 3 月进行了文献检索。不幸的是，由于研究数量太少，无法进行荟萃分析，对于各种临床方面的主题，研究之间无法相互比较，甚至对于作为输卵管通畅性测试的可靠性也无法进行比较。
九项小型研究得出结论，2D 和 3D-HyFoSy 的准确性和有效性作为输卵管通畅性测试可与 HSG 或 HyCoSy 相媲美，甚至更好。无论是否使用多普勒技术，3D-HyFoSy 似乎都没有优于实时 2D-HyFoSy 的优势。五项研究报告了 HyFoSy 期间的疼痛和不适，得出的结论是 HyFoSy 是一种耐受性好，疼痛较轻的程序，与 HSG 相比，无需使用镇痛药。有研究表明，在该程序后的前三个周期中妊娠率增加，但在没有研究将 HyFoSy 后的妊娠结局与其他干预或无干预进行比较。
HyFoSy 是一种有前途且安全的 HSG 替代方法，在准确性和有效性方面。HyFoSy 没有辐射和碘暴露，并且是一种耐受性好且疼痛较轻的程序，与 HSG 相比，无需使用镇痛药。但是，需要进行更多的研究才能明确说明 HyFoSy 的治疗效果。
