Hysterosalpingo contrast sonography (HyCoSy) and its future role within the investigation of infertility in Europe.

An important part of any protocol for investigation of the infertile couple is the assessment of Fallopian tube patency in the woman, as this can influence the future course of treatment. X-ray hysterosalpingography and laparoscopy and dye tubation are currently the main procedures for investigating tubal patency, but the recent development of hysterosalpingo contrast sonography (HyCoSy) may offer some benefits over these two methods. HyCoSy involves a transvaginal ultrasound investigation of the Fallopian tubes both before and after the injection of an echo-enhancing agent into the tubes via the uterine cavity. Evidence of tubal flow with B-mode scanning is indicative of tubal patency. Clinical data using the echo-enhancing agent, Echovist, in over 600 patients, in addition to technical aspects of the HyCoSy procedures are reviewed. The data presented indicate that the sensitivity and specificity of HyCoSy compare favorably with the current 'gold standard' techniques. HyCoSy is a safe, well-tolerated and relatively inexpensive procedure, which can be carried out in a short time during an outpatient consultation. Combining these undoubted benefits with the clinical results obtained to date would indicate that HyCoSy has the potential to be employed as a reliable and well-accepted procedure for assessing tubal patency as part of the investigation of infertility. Copyright 1994 International Society of Ultrasound in Obstetrics and Gynecology