August 23rd, 2019

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Evaluation of Tubal Patency with a Saline-Air Device: Can We Move Back to the Office?
Authors:  Rachel M. Beverley, M.D., Shruti Malik, M.D., Robert L. Collins, M.D., Katie Jean, B.S., and Joseph S. Sanfilippo, M.D., M.B.A.
  OBJECTIVE: To assess the performance of office-based hysterosalpingocontrast sonography (HyCoSy) using the FemVue air-saline device as compared to traditional fluoroscopic hysterosalpingogram (HSG) for evaluating tubal patency in women presenting with infertility.

STUDY DESIGN: This was a prospective descriptive study completed in a university-based infertility practice. Women with primary or secondary infertility who presented for evaluation were enrolled in the study and underwent both office-based HyCoSy and HSG. Primary outcome was the assessment of right and left fallopian tube patency. Uterine cavity assessment, presence of hydrosalpinx, and patient discomfort during each procedure were assessed as secondary outcomes.

RESULTS: Tubal patency was evaluated in 20 patients aged 21–43 years. Tubal patency was confirmed in 32/39 (82%) fallopian tubes via HyCoSy and in 34/39 (87%) fallopian tubes via HSG, with a 77% concordance rate between HyCoSy and HSG techniques. Uterine cavity filling defect was detected in 5 patients. Only 1 of those 5 defects was detected on both HyCoSy and HSG, for a concordance rate of 16/20 (80%).

CONCLUSION: Tubal patency assessment with HyCoSy using the FemVue device is comparable to HSG and is a convenient, well-tolerated method which may be performed easily in the office as part of the infertility evaluation.
Keywords:  air; air-saline device; assisted reproductive technologies; fallopian tube; fallopian tube diseases/diagnosis; fallopian tube diseases/diagnostic imaging; fallopian tube patency tests/methods; HyCoSy; hysterosalpingocontrast sonography; hysterosalpingography; infertility, female; tubal patency
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