Tubal Patency Check by ExEm Foam - HyFoSy (Hysterosalpingo Foam Sonography)

HyFoSy is an ultrasound-guided procedure to assess the patency of the fallopian tubes. Almost every third woman with infertility problems has a partial or complete blockage of one or both fallopian tubes. A tubal patency test is one of the primary tests for finding out the causes of infertility. In the case of patency of the fallopian tubes, 20% of women spontaneously conceive within the next 3 months after the procedure.

This procedure can be used to assess whether laparoscopic or hysteroscopic sterilization was successful.

HyFoSy does not require surgical intervention (laparoscopic tubal patency examination) or X-rays (hysterosalpingographic tubal patency examination). The effectiveness of HyFoSy is as good as hysterosalpingography, where there are 5-10% false-positive results, apparently showing that the fallopian tubes are closed, but later laparoscopy reveals that the fallopian tubes are permeable to contrast material.

The HyFoSy procedure begins with a gynecological intravaginal ultrasound examination, during which the position and structure of the uterus, ovaries and fallopian tubes are checked. After that, a gynecological mirror is placed in the vagina and the cervix is ​​cleaned with a disinfectant. A special catheter is passed through the cervix, the gynecological speculum is removed and through the catheter foam is injected into the uterus, obtained by mixing ExEm® gel based on organic cellulose with water and air. The movement of air bubbles in this foam in the uterus and fallopian tubes can be monitored with a transvaginal ultrasound sensor. If the fallopian tubes are passable, the ExEm® gel foam goes into the abdominal cavity of the fallopian tubes, where it is absorbed during the next 24 hours. If the fallopian tubes are closed, the ExEm® gel cannot enter the fallopian tubes, or it can be seen in which part of the fallopian tube the blockage occurs.

Years ago, the HyCoSy procedure was used in Estonia to assess the patency of the fallopian tubes, where Echovist® solution containing galactose microparticles (Bayer Schering Pharma AG, Berlin, Germany) was used to assess the patency of the fallopian tubes. Since galactose allergy is well-known and the procedure was accompanied by 5%, in addition to the pain reaction, nausea, vomiting, drop in blood pressure, shortness of breath and sweating - the use of this preparation has been restricted in most countries.

The HyFoSy procedure uses the non-embryotoxic ExEm® gel (Gynekologiq BV, Delft, The Netherlands), which contains hydroxyethyl cellulose and glycerol, which has no observed allergic reactions or infections and is less painful for the patient than Echovist® solution. ExEm® gel was registered by the Fetal Ultrasound Center at the Estonian Health Board on 05.12.2012.

If pregnancy occurred during the menstrual cycle when the HyFoSy procedure was performed, it does not endanger the developing fetus.

HyFoSy is a safe, accurate, non-embryotoxic alternative to laparoscopic and hysterosalpingographic tubal patency testing that can be performed on an outpatient basis under ultrasound guidance and does not require surgical intervention, anesthesia, or x-rays.

Fallopian tube patency test - HyFoSy ( Hysterosalpingo Foam Sonography )

The price of the procedure includes the doctor's consultation fee