Serene Liqing Lim1, Jacqueline Jingjin Jung2, Su Ling Yu2, Hemashree Rajesh2. 1. Centre of Assisted Reproduction, Department of Obstetrics & Gynaecology, Singapore General Hospital, Singapore, Singapore. Electronic address: serene.lim.l.q@sgh.com.sg. 2. Centre of Assisted Reproduction, Department of Obstetrics & Gynaecology, Singapore General Hospital, Singapore, Singapore.
Abstract
OBJECTIVE: A randomized controlled selective cross-over trial was performed to compare the diagnostic yield and efficacy of ExEm foam (HyFoSy) with saline medium (HyCoSy) as a contrast agent for hysterosalping-contrast sonography in subfertile patients. STUDY DESIGN: 40 patients were randomized into HyCoSy with saline medium and HyFoSy with ExEm foam. Tubal patency were assessed according to pre-determined objective criteria that classified tubes based on degree of certainty in tubal patency. Selective cross-over testing with the other medium was performed in patients who had at least one possibly occluded or unexaminable tube on the initial test. RESULTS: 80 tubes were evaluated. On initial testing, the proportion of tubes that were classified as patent was higher with HyFoSy compared to HyCoSy (70.0% vs 40.0%, p=0.01). A higher proportion of patients in the HyCoSy group required crossover testing [80.0% (16/20) vs 45.0% (9/20), p=0.02]. On cross-over testing, 41.7% (10/24) of possibly occluded or unexaminable tubes in the HyCoSy group were re-classified as patent when examined with Ex-Em foam, compared to 8.3% (1/12) of possibly occluded or unexaminable tubes in the HyFoSy group (p=0.03). CONCLUSION: ExEm foam medium (HyFoSy) might improve the diagnostic yield and efficacy over saline medium (HyCoSy) for hysterosalpingsonography.
OBJECTIVE: A randomized controlled selective cross-over trial was performed to compare the diagnostic yield and efficacy of ExEm foam (HyFoSy) with saline medium (HyCoSy) as a contrast agent for hysterosalping-contrast sonography in subfertile patients. STUDY DESIGN: 40 patients were randomized into HyCoSy with saline medium and HyFoSy with ExEm foam. Tubal patency were assessed according to pre-determined objective criteria that classified tubes based on degree of certainty in tubal patency. Selective cross-over testing with the other medium was performed in patients who had at least one possibly occluded or unexaminable tube on the initial test. RESULTS: 80 tubes were evaluated. On initial testing, the proportion of tubes that were classified as patent was higher with HyFoSy compared to HyCoSy (70.0% vs 40.0%, p=0.01). A higher proportion of patients in the HyCoSy group required crossover testing [80.0% (16/20) vs 45.0% (9/20), p=0.02]. On cross-over testing, 41.7% (10/24) of possibly occluded or unexaminable tubes in the HyCoSy group were re-classified as patent when examined with Ex-Em foam, compared to 8.3% (1/12) of possibly occluded or unexaminable tubes in the HyFoSy group (p=0.03). CONCLUSION: ExEm foam medium (HyFoSy) might improve the diagnostic yield and efficacy over saline medium (HyCoSy) for hysterosalpingsonography.
Authors: Nienke van Welie; Joukje van Rijswijk; Kim Dreyer; Machiel H A van Hooff; Jan Peter de Bruin; Harold R Verhoeve; Femke Mol; Wilhelmina M van Baal; Maaike A F Traas; Arno M van Peperstraten; Arentje P Manger; Judith Gianotten; Cornelia H de Koning; Aafke M H Koning; Neriman Bayram; David P van der Ham; Francisca P J M Vrouenraets; Michaela Kalafusova; Bob I G van de Laar; Jeroen Kaijser; Arjon F Lambeek; Wouter J Meijer; Frank J M Broekmans; Olivier Valkenburg; Lucy F van der Voet; Jeroen van Disseldorp; Marieke J Lambers; Rachel Tros; Cornelis B Lambalk; Jaap Stoker; Madelon van Wely; Patrick M M Bossuyt; Ben Willem J Mol; Velja Mijatovic Journal: Hum Reprod Date: 2022-05-03 Impact factor: 6.353