EP25.05: Tubal patency testing in subfertile women: a randomised study comparing spontaneous pregnancy rates, complication rates and cost of HyFoSy versus HSG

Abstract

To compare HyFoSy versus HSG in tubal patency assessment for patients with unexplained subfertility. To compare the difficulty, duration, and cost of both tests and record the incidence of spontaneous pregnancy within 3-6 months post-procedure. Patients with suspected unexplained subfertility attending our outpatient clinic at Cairo and South Valley University hospitals were randomised to undergo one of two tubal patency tests: HyFoSy or HSG. Both procedures were compared regarding technical difficulty, cost of technique, pain perceived by the patient using the visual analogue scale, complication rates, and occurrence of pregnancy within 3-6 months. Two hundred patients were randomised, 100 in each group. 93 underwent HyFoSy, of whom 81 showed bilateral tubal patency, 8 unilateral block, and 4 bilateral. 97 underwent HSG, 76 had bilateral patent tubes, 16 unilateral block and 5 bilateral block. The mean age of the patients was comparable between both groups. Cervical cannulation was significantly easier in the HyFoSy group. Using the Visual Analogue Scale, pain perceived was significantly less in the HyFoSy group. The mean mL of foam needed to be injected in HyFoSy cases was significantly less than dye used for the HSG: 8.10 ± 1.16 versus 21.26 ± 2.97 (P < 0.001). The duration of the tests in minutes was significantly less for HyFoSy: 4.95 ± 0.81 versus 21.41 ± 2.95 for HSG (P < 0.001). The cost of both tests in Egyptian pounds proved HyFoSy to be 8 times cheaper than HSG. There was no significant difference in the complication rates between both test groups, including PID, hypersensitivity, fever, or spotting. Within 3-6 months follow-up 26 patients of the HyFoSy group were spontaneously pregnant (27.9%), while in the HSG group, 16 (16.5%) were pregnant (P.05). HyFoSy, an ultrasound-based tubal patency test, compared to HSG, is easier, cheaper, takes less time with less pain, with similar and comparable complication and spontaneous pregnancy rates within 3-6 months.