OP20.02: HyCoSy for assessment of tubal patency: are findings and procedure success rates different in women who have previously been pregnant?

Hysterosalpingo contrast sonography (HyCoSy) is the preferred method of tubal patency assessment in women who have secondary infertility, previous intra-abdominal surgery and an increased BMI but is also used for women with primary infertility where laparoscopy is deemed unnecessary. This study aimed to review all cases referred for HyCoSy because of infertility over a three year period. The success rate and findings in women with primary rather than secondary infertility were compared. Casenotes from 1/1/03 to 31/12/05 were reviewed. Data were computerised and analysed. Chi square was used to compare rates. Three hundred and seventy one women attended. Two hundred and one women had a previous intrauterine pregnancy (IUP). The procedure was tolerated in 96.5% of all patients. Reasons for failure included inability to cannulate the cervix, pain and syncope. The uterine cavity was normal in 92.7% of procedures and tubal patency was confirmed in over 80% of patients studied. Table 1 demonstrates the findings for women who have had a previous intrauterine pregnancy compared with those who have not. HyCoSy has a high success rate and a low complication rate. There was no difference in patient tolerance or complication rate whether or not there had been a previous pregnancy. The incidence of tubal patency was higher in women with no previous (intrauterine) pregnancy. This finding may be explained by the fact that women with primary infertility with suspected PID or endometriosis would have had laparoscopy and dye rather than HyCoSy for assessment of tubal patency.