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Fallopian-Tube Patency Testing

 

The HyFoSy test is an ultramodern method of examining the patency of the fallopian tubes in an outpatient setting.

Medfemina Health Centre introduced the HyFoSy study to its offer as the first facility in Wrocław. The examination is performed by a certified specialist in gynaecology and obstetrics and does not require exposing the patient to harmful X-rays as in other methods

What is the 3D/4D HyFoSy examination?

This is a test to check the patency of the fallopian tubes. The fallopian tubes are the conduits where the egg and sperm come together and fertilize if they are unobstructed (open). Adhesions of fallopian tubes, which make fertilization difficult or impossible, may result from adnexitis, asymptomatic infections of the reproductive system, surgery in the abdomen or pelvis minor, or may result from developmental anomalies of the female reproductive system.

The test has the added benefit of assessing the shape and structure of the uterus and any uterine abnormalities such as polyps, myomas and adhesions that may prevent pregnancy.

 

What is the course of 3D/4D HyFoSy examination?

After an introductory talk with the doctor and signing a consent form, the patient is prepared and invited to the gynaecological examination chair. After application of the disinfectant fluid an ultrasound transducer is inserted into the vagina and a special sterile ExEm Foam is gently injected through the catheter to fill the uterine cavity and fallopian tubes, making them clearly visible on ultrasound. The whole examination normally takes about 15-20 minutes and is carried out under sterile conditions (sterile disposable equipment, sterile instruments, sterile gloves). During the examination, each step is discussed in detail and the patient is kept informed of the next steps to be taken.

Then, a disposable gynaecological speculum is inserted into the vagina, and then a thin and flexible silicone catheter with a balloon is inserted into the cervix. After removal of the speculum

The examination is performed by a certified doctor (British Ultrasound Society BMUS certificate) using GE’s Voluson ultrasound machine with 3D/4D, B-Flow and HDlive options.

 

What is ExEmFoam?

It is a special foam developed in 2010 by a Dutch team of experts in the diagnosis of infertility, who sought to obtain a completely safe preparation, based on organic ingredients, not causing allergic reactions caused by other radiological contrasts and, above all, diagnostically reliable.

ExEm foam meets all the above-mentioned assumptions, moreover, it is safe for oocytes and sperm, so there are no contraindications to try to get pregnant in the same cycle in which the patency of fallopian tubes was tested. Its ingredients are hydroxyethylcellulose, glycerol, and distilled water, prepared for use in two sterile-packed syringes. When the ingredients are mixed, special microbubbles are formed, enabling ultrasound imaging. After the test, the foam is absorbed and naturally excreted from the body.

Are there any complications of the 3D/4D HyFoSy study?

There is a slight risk of pelvic infection after the examination, therefore the eligibility criteria are very strictly adhered to before each examination. To minimize the risk of infection, a current cervical smear is checked, the patient is given antiseptic globules, and the test is performed under sterile conditions. Some patients will be advised to take a prophylactic antibiotic before and after the test during the pre-test consultation.

Immediately after the test, you may experience minor spotting, which usually resolves spontaneously after 1-2 days, and transient non-severe uterine cramping, similar to minor menstrual pain. Therefore, about an hour before the examination, it is recommended to take two tablets of ibuprofen (e.g. Ibum, Nurofen, 2x 200 mg) or paracetamol (e.g. Apap, Panadol, 2x 500 mg), which minimizes these experiences.

 

What are other methods of testing for fallopian tube patency?

Methods that check whether the fallopian tubes are clear involve administering contrast fluid through the cervix and watching the contrast flow out of the fallopian tubes. We may select from:

  • HyCoSy (HysteroContrastSonography) – patency testing by observing the flow of saline solution through the fallopian tubes, a method based on ultrasound but not diagnostically reliable due to poor fluid visualization with ultrasound;
  • HSG (hysterosalpingography) – X-ray imaging that exposes the patient (including her ovaries with reproductive cells) to a dose of X-rays during the test, has high reliability but is usually painful for the patient, so it is currently recommended only as a verification test when there is doubt in other contrast tests;
  • laparoscopy with contrast application – an invasive method, consisting in administering contrast to the fallopian tubes during surgery under general anaesthesia, reliable, but associated with hospitalization and exposure of the patient to perioperative risk. It is ideal during a laparoscopic procedure for another reason as a supplement to diagnostics.

 

How to prepare for the 3D/4D HyFoSy test?

  1. Arrival on an empty stomach is not required, and you may drink immediately before the test.
  2. Do not have intercourse during the cycle in which the test is scheduled-or use a condom-until 24 hours after the test.
  3. You should start using vaginal globules according to the prescription given at the consultation 3 days before the test.
  4. The urinary bladder should be emptied immediately before the test.
  5. To increase the safety of the test, the patient should not show signs of any infection – whether fever, cold, herpes or signs of genital tract infection.
  6. You are requested to bring a current cytology smear result, cervical smear results, and results of previous uterine and fallopian tube examinations.

Medfemina patients receive instructions on what to do when visiting their doctor.

All other patients are welcome to schedule an appointment before the examination – preferably in the cycle prior to the scheduled 3D/4D HyFoSy.

During the appointment, a cervical swab may be taken, depending on the patient’s will.

If you have any questions, please contact our reception.

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