Feasibility, tolerability, and safety of hysterosalpingo-foam sonography (hyfosy). multicenter, prospective Spanish study.

Autor: Engels V; Hospital Universitario Puerta de Hierro Majadahonda, Spain. Electronic address: v_engels_77@hotmail.com., Medina M; Hospital Materno Infantil Las Palmas de Gran Canaria, Spain., Antolín E; Hospital Materno Infantil La Paz, Spain., Ros C; Hospital Clinic Barcelona, Spain., Amaro A; Hospital Materno Infantil Las Palmas de Gran Canaria, Spain., De-Guirior C; Hospital Materno Infantil La Paz, Spain; Hospital Clinic Barcelona, Spain., Manzour N; Clínica Universitaria De Navarra, Spain., Sotillo L; Hospital Materno Infantil La Paz, Spain., De la Cuesta R; Hospital Universitario Puerta de Hierro Majadahonda, Spain., Rodríguez R; Hospital Materno Infantil La Paz, Spain., San-Frutos L; Hospital Universitario Puerta de Hierro Majadahonda, Spain., Peralta S; Hospital Materno Infantil Las Palmas de Gran Canaria, Spain., Martin-Martínez A; Hospital Materno Infantil Las Palmas de Gran Canaria, Spain., Alcázar JL; Clínica Universitaria De Navarra, Spain.
Jazyk: angličtina
Zdroj: Journal of gynecology obstetrics and human reproduction [J Gynecol Obstet Hum Reprod] 2021 May; Vol. 50 (5), pp. 102004. Date of Electronic Publication: 2020 Nov 23.
DOI: 10.1016/j.jogoh.2020.102004
Abstrakt: Objective: To determine the feasibility,tolerability, and safety of the ultrasound assessment of tubal patency using foam as contrast.
Methods: This was a prospective multicenter study of 915 infertile nulliparous women scheduled for sonohysterosalpingography with foam instillation (HYFOSY) for tubal patency testing as a part of the fertility workup. Clinical and sonographic data were recorded into a web-shared database. Tubal patency, cervical catheterization, pain during the procedure and post-procedural complications were collected. Patients reported discomfort or pain experienced during the procedure with a visual analogue scale (VAS) score.
Results: Nine hundred fifteen women were included in the final analysis. Median age was 34 (range, 21-45) years and median body mass index was 23 (range, 16-41) kg/m2. Of 839 women, only 8(0.95 %) cases were abandoned due to impossibility of introducing the intracervical catheter. Most of the cervical os were easily cannulated with either paediatric nasogastric probes or special catheter for intrauterine insemination / sonohysterosalpingography 688/914(75.3 %). With a median instillation of 4 mL (range 1-16) of foam, both tubes were identified in 649/875 (70.9 %) patients, while unilateral patency was observed in 190/875 (20.8 %). Only 36/875 (3.9 %) of the women had bilateral tubal obstruction. The median VAS score for perception of pain during HyFoSy examination was 2 (range 0-10), and only 17 (1.9 %) of women reported severe pain (VAS ≥ 7). Pain was unrelated to tubal patency or tubal blockage. Unexpectedly, difficult cervical catheterizations that needed tenaculum, were more likely associated with mild pain during procedure [nasogastric probe group 176/289 (70.9 %) vs. insemination catheter group 166/399 (41.6 %) vs. tenaculum group 190/218(87.2 %) p < 0.001]. Finally, among 915 patients, we only noticed 3 (0.32 %) complications of the technique: two vasovagal episodes and a mild urinary infection.
Conclusion: HYFOSY is a feasible, well-tolerated and safe technique for the evaluation of tubal patency in infertile women.
(Copyright © 2020 Elsevier Masson SAS. All rights reserved.)
Databáze: MEDLINE
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