A prospective observational 2D/3D/4D hysterosalpingo contrast sonography using mixture of lignocaine gel and normal saline as contrast in patients undergoing infertility investigations

Hysterosalpingo contrast sonography (HyCoSy) is a well-tolerated diagnostic tool to examine the uterus, ovaries, fallopian tubes, and pelvis. It has some advantages over other techniques, such as X-ray hysterosalpingography (HSG), laparoscopy, and dye intubation. This prospective study aimed to investigate the use of 2D/3D/4D HyCoSy, using lignocaine gel and normal saline as a contrast agent, to assess tubal patency and uterine abnormalities in infertile women. More than 5000 infertile cases were evaluated by HyCoSy 2D/3D/4D test using lignocaine gel as a contrast agent during the period of 2016–2022 at Shilpa Scanning Center, Andhra Pradesh. Among the subjects studied, a total of 850 cases were randomly selected to assess tubal patency. Of 850 patients, 54 had X-ray HSG reports that were reassessed using 2D/3D/4D HyCoSy. During the test, we also assess the intensity of the pain. Out of 850 infertile patients, 603 (70.94%) had primary infertility, and 247 (29.06%) had secondary infertility. The fallopian tubes were found to be patent in 702 (82.59%) of these patients, while 80 (9.41%) had unilateral occlusion and 68 (8%) had bilateral occlusion. Among the 54 patients with previous reports of X-ray HSG, three were misdiagnosed as bilateral obstruction and six as unilateral obstruction, and these misdiagnoses were confirmed by 2D/3D/4D HyCoSy using lignosal contrast and laparoscopic dye testing. During the HyCoSy procedure, 772 women (90.82%) reported mild pain that was less severe than menstrual pain. The 2D/3D/4D-HyCoSy with lignosal gel as a contrast agent could be a promising tool for detecting fallopian tube patency and uterine abnormalities.