P03.08: “One shot” fertility work‐up: combining two‐ and three‐dimensional ultrasound, hydrosonography and foam hysterosalpingo‐sonography

Evaluation of the uterine cavity, tubal patency and the ovaries is an essential part of fertility work-up, traditionally done by two-dimensional ultrasound (2D US), hysterosalpingography (HSG) or hysteroscopy. The implementation of foam hysterosalpingo-sonography (HyFoSy) and hydrosonography allows a complete fertility work-up by ultrasound. Our study evaluates the value of a single ultrasound examination for fertility work-up, starting with 2D US followed by three-dimensional ultrasound (3D US), hydrosonography and HyFoSy. An observational study of all patients referred for HyFoSy at a single tertiary centre, between May 2018 and March 2019. Patients underwent 2D US of uterus and ovaries, 3D US of uterus, HyFoSy and hydrosonography. Data were recorded prospectively and were analysed retrospectively. During the study period 75 patients were examined, four of them were excluded from the study because of failed catheter insertion. Among the remaining 71, 2D US revealed 2 endometriomas, 9 hydrosalpinges, and signs of adenomyosis in 11 patients. 3D US demonstrated uterine malformations in two patients. Following hydrosonography, uterine cavity adhesions, endometrial polyps and fibroids protruding into the uterine cavity were observed in 4, 6 and 3 patients respectively. In the four women with uterine adhesions foam failed to reach the tubes, precluding tubal patency evaluation. Among the remaining 67, 14 had unilateral occlusion, nine had bilateral occlusion and 44 had two patent tubes. Our study investigates a new “One shot” strategy for fertility work-up. Compared to HSG and hysteroscopy, ultrasound identifies a wider scope of pathologies. Integration of four different sonographic methods allows the evaluation of uterine cavity and walls, tubes and ovaries by a single examination, for patients' convenience. We therefore suggest to consider this strategy as an integrated exam in routine fertility work-up. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.