Evaluation of the uterine cavity and fallopian tubes in one step in patients undergoing assisted reproductive technology treatment: Hysterosalpingofoam sonography (hyfosy) in combination with hysteroscopy

Year 2021, Volume: 3 Issue: 2, 27 - 32, 25.06.2021

Hulusi Zeyneloglu , Yusuf Aytaç Tohma , Göğşen Önalan , Emre Günakan

https://doi.org/10.46969/ezh.940157

Abstract

Aim: To report on the utilization of hysterosalpingo-foam sonography (HyFoSy) with hysteroscopic evaluation for selected
patients undergoing Assisted Reproductive Technology Treatment (ART), whereby we aimed to assess the effectiveness
of HyFoSy before hysteroscopy.
Material and Method: This retrospective study included 36 infertile women referred to Baskent University’s Ankara
Hospital Infertility Clinic in 2017-2019. HyFoSy was applied with hysteroscopy in one step for patients who had not
previously been evaluated for tubal patency or who had to be re-evaluated.
Results: Two patients were diagnosed with tubal obstruction by HyFoSy and were treated with hysteroscopic tubal
catheterization, and tubal patency was obtained after this procedure. HyFoSy was applied in seven patients (19.49%)
because their previous hysterosalpingography (HSG) reports were doubtful. Although previous HSG had shown tubal
obstruction in three patients, the standard passage of the foam from the fallopian tubes to the abdominal cavity was
observed when HyFoSy was applied.
Conclusion: The one-step method that we apply in our clinic seems appropriate for both patients and clinicians because
it speeds up the evaluation steps of the uterine cavity and fallopian tubes before the next ART attempt.

Keywords

Hysteroscopy, infertility, hysterosalpingo-foam sonography, hystero-contrastsonography

Project Number

KA19/360

Yardımcı üreme teknolojileri tedavisi uygulanacak hastalarda uterin kavitenin ve fallop tüplerinin tek adımda değerlendirilmesi: Histeroskopi ile birlikte histerosalpingo-köpük sonografi (hyfosy)

Abstract

Amaç: Biz bu çalışmada, yardımcı üreme teknolojileri tedavisi uygulanacak seçilmiş hastalarda tedavi öncesinde aynı
seansta uygulanan histeroskopi ve histerosalpingo-köpük sonografinin etkinliğini değerlendirmeyi amaçladık.
Gereç ve Yöntem: Bu retrospektif çalışma, 2017-2019 yılları arasında Başkent Üniversitesi Ankara Hastanesi İnfertilite
Kliniği'ne başvuran 36 infertil kadını içermektedir. Merkezimizde, daha önce tubal açıklığı açısından değerlendirilmemiş
veya yeniden değerlendirilmesi gereken hastalar için bir adımda histeroskopi ile HyFoSy uygulanmaktadır ve çalışmaya bu
hastalar dahil edilmiştir.
Bulgular: İki hastaya HyFoSy ile tubal obstrüksiyon tanısı konuldu ve histeroskopik tubal kateterizasyon ile tedavi edildi
ve bu işlemden sonra tubal açıklık elde edildi. Önceki histerosalpingografi (HSG) raporları şüpheli olduğu için 7 hastaya
(%19,49) HyFoSy uygulandı. Üç hastada, önceki HSG incelemesinde tubal obstrüksiyon görülmesine rağmen, HyFoSy
uygulandığında köpüğün fallop tüplerinden karın boşluğuna normal geçişi gözlendi.
Sonuç: Kliniğimizde uyguladığımız bu tek adımlı yöntem hem hastalar hem de klinisyenler için uygun görünmektedir,
çünkü uygulanan yöntem bir sonraki ART girişiminden önce uterin kavitenin ve fallop tüplerinin değerlendirme adımlarını
hızlandırmaktadır.

Keywords

Histeroskopi, İnfertilite, Histerosalpingo-köpük Sonografi, Histerokontrast sonografi

Supporting Institution

Başkent Üniversitesi

Project Number

KA19/360

References

• Zeyneloglu, H.B., A. Arici, and D.L. Olive, Adverse effects of hydrosalpinx on pregnancy rates after in vitro fertilization-embryo transfer. Fertil Steril 1998; 70:492-499.
• Bosteels J, van Wessel S, Weyers S, et al., Hysteroscopy for treating subfertility associated with suspected major uterine cavity abnormalities. Cochrane Database Syst Rev 2018; 12:CD009461.
• Handelzalts JE, Levy S, Peled Y, et al., Information seeking and perceptions of anxiety and pain among women undergoing hysterosalpingography. Eur J Obstet Gynecol Reprod Biol 2016; 202:41-44.
• Suzuki, T, Shibahara H, Hirano Y, et al., Feasibility and clinical significance of endoluminal assessment by transvaginal salpingoscopy during transvaginal hydrolaparoscopy in infertile women. J Minim Invasive Gynecol 2005; 12:420-425.
• Volpi E, De Grandis T, Zuccaro G, Patriarca A, Sismondi P. A new technique to test tubal patency under transvaginal sonographic control. Acta Obstet Gynecol Scand 1994; 73:797-801.
• Maheux-Lacroix S, Boutin A, Moore L, et al., Hysterosalpingosonography for diagnosing tubal occlusion in subfertile women: a systematic review with meta-analysis. Hum Reprod 2014; 29:953-963.
• Emanuel MH and N Exalto. Hysterosalpingo-foam sonography (HyFoSy): a new technique to visualize tubal patency. Ultrasound Obstet Gynecol 2011; 37:498-499.
• Piccioni MG, Riganelli L, Filippi V, et al. Sonohysterosalpingography: Comparison of foam and saline solution. J Clin Ultrasound 2017; 45:67-71.
• Van Schoubroeck D, Van den Bosch T, Ameye L, Boes AS, D'Hooghe T, Timmerman D. Pain during Fallopian-tube patency testing by hysterosalpingo-foam sonography. Ultrasound Obstet Gynecol 2015; 45:346-350.
• Tanaka K, Chua J, Cincotta R, Ballard EL, Duncombe G. Hysterosalpingo-foam sonography (HyFoSy): Tolerability, safety and the occurrence of pregnancy post-procedure. Aust N Z J Obstet Gynaecol 2018; 58:114-118.
• Bosteels J, Weyers S, Puttemans P, et al., The effectiveness of hysteroscopy in improving pregnancy rates in subfertile women without other gynaecological symptoms: a systematic re-view. Hum Reprod Update 2010; 16:1-11.
• Fatemi HM, Kasius JC, Timmermans A, et al., Prevalence of unsuspected uterine cavity ab-normalities diagnosed by office hysteroscopy prior to in vitro fertilization. Hum Reprod 2010; 25:1959-1965.
• Emanuel MH, van Vliet M, Weber M, Exalto N. First experiences with hysterosalpingo-foam sonography (HyFoSy) for office tubal patency testing. Hum Reprod 2012; 27:114-117.
• El-Toukhy T, Campo R, Khalaf Y, et al., Hysteroscopy in recurrent in-vitro fertilisation failure (TROPHY): a multicentre, randomised controlled trial. Lancet 2016; 387:2614-2621.
• Smit JG, Kasius JC, Eijkemans MJC, et al., Hysteroscopy before in-vitro fertilisation (in-SIGHT): a multicentre, randomised controlled trial. Lancet 2016; 387:2622-2629.
• Cicinelli E, Matteo M, Tinelli R, et al. Prevalence of chronic endometritis in repeated unex-plained implantation failure and the IVF success rate after antibiotic therapy. Hum Reprod 2015;30:323-330.
• Cao H, You D, Yuan M, Xi M. Hysteroscopy after repeated implantation failure of assisted reproductive technology: A meta-analysis. J Obstet Gynaecol Res 2018; 44:365-373.
• Parry JP, Riche D, Rushing J, Linton B, Butler V, Lindheim SR. Performing the Parryscope technique gently for office tubal patency assessment. Fertil Steril 2017; 108:718.
• Karande CV, Pratt ED, Gleicher N. The assessment of tubal functional status by tubal perfu-sion pressure measurements. Hum Reprod Update 1996; 2:429-433.
• Carta G, Palermo P, Pasquale C, et al. Office hysteroscopic-guided selective tubal chro-mopertubation: acceptability, feasibility and diagnostic accuracy of this new diagnostic non-invasive technique in infertile women. Hum Fertil (Camb) 2018; 21:106-111.
• Habibaj J, Kosova H, Bilali S, Bilali V, Qama D. Comparison between transvaginal sonogra-phy after diagnostic hysteroscopy and laparoscopic chromopertubation for the assessment of tubal patency in infertile women. J Clin Ultrasound 2012; 40:68-73.
• Gordts S, Campo R, Puttemans P, et al. Investigation of the infertile couple: a one-stop outpa-tient endoscopy-based approach. Hum Reprod 2002; 17:1684-1687.
• Magos A, Al-Khouri A, Scott P, et al. One stop fertility clinic. J Obstet Gynaecol 2005; 25:153-159.
• Hrehorcak M, Nargund G. "One-Stop" fertility assessment using advanced ultrasound tech-nology. Facts Views Vis Obgyn 2011; 3:8-12.