Evaluation of tubal patency and its impact on ovarian blood flow and function: a comparison of hysterosalpingography and HyCoSy

Objective: To investigate Hysterosalpingo Contrast Sonography (HyCoSy) as a safe, effective, easy, and cheaper approach to measure tubal patency than hysterosalpingography (HSG) and to correlate better ovarian function, endometrial and ovarian blood flow, and conception rates in infertile women. Methodology: This cross-sectional study included 40 infertile women between 22 and 42 years age; 20 of them had HSG on day 6 or 7 of cycle and 20 HyCoSy with normal saline and 100 mg hydrocortisone. All underwent the protocol of 75 iu gonal F sc on days 2 and 3, with clomiphene 50 mg twice daily from days 2 to 7 or letrizole 2.5 twice daily from days 3 to 8 (around day 14). Evaluated criteria: resistance index (RI) and perfusion index (PI) of ovarian vessels by Doppler ultrasound, number and size of follicles for both groups, endometrial thickness, endometrial pattern, zones of blood flow to endometrium. Then HCG to promote ovulation and progesterone to support luteal phase. Results: HSG group mean age was 29.7 6 HYCOSY group age was 29 6 years. 82.1% of HSG females and 90.1% of HyCoSy females had 2nd infertility. Females undergoing HSG had 42.9% I zone and 65.6% IV zone. Females undergoing HSG and HyCoSy had 1 follicle, respectively. 68.8% of HyCoSy females were pregnant. HSG and HyCoSy had different RI, thickness. HyCoSy was thicker and had less RI than HSG. HSG and HyCoSy had similar numbers and sizes of follicles. Conclusion: HyCoSy was a safe, effective, easy, and cheaper way to evaluate tubal patency than HSG, less RI and increase endometrium thickness.