EP32.03: Outcome of hysterosalpingo‐foam‐ultrasonography as an initial tubal patency assessment method in patients with subfertility

Follow up of subfertile patients undergoing hysterosalpingo-foam-ultrasonography (HyFoSy) tubal patency testing as part of their fertility work-up, as regards; spontaneous conception within 6 months or > 6 months of the procedure, conception by ART, post procedure complications; pain, fever, PID, admission to hospital. All patients were referred for tubal patency testing using HyFoSy. Previsit antibiotic and analgesic treatment was prescribed. History taking and basic gynecological ultrasound was done, followed by insertion of a pediatric foleys balloon catheter just beyond the internal os and inflated with 2 cc of saline. The foam was prepared by mixing 2 cc of lidocaine gel with 15-20 cc of saline until a whitish foam was created. Under TV US vision the foam flow through both tubes was observed using 2D US, once spill of the echogenic gel was seen around both ovaries injection of the foam was stopped, all examinations were recorded as 2D cine loops. One hundred and twenty-two women were followed up over a period of 4 years from November 2018 till December 2022, using direct phone calls. Full outcome data was available for 67 patients. The mean age of the patients was 32.6, 36 had primary infertility, while 31 had secondary infertility. 56 cases had both tubes patent, 3 had unilateral tubal block and 8 had bilateral block. 34 women got pregnant after the procedure, 22 spontaneously, within 6 months of the procedure (64.7%), 6 after > 12 months and 6 after undergoing an ART procedure. Nine women had complaints in the form of pain (5), bleeding (1), fever (3). All symptoms were relieved spontaneously within 24 hours with mild analgesics and only one of the patient's needed admission to hospital with IV antibiotics. HyFoSy is a simple ultrasound clinic-based test for tubal patency. It could increase the rate of spontaneous pregnancy within 6 months of the procedure with minimal treatable side effects.