The Tolerance And Safety Of Hysterosalpingo Contrast Sonography(Hycosy) With Sonovue For Outpatient Investigation Of Infertile Women

Objective: Tubal and uterine cavity diseases commonly compromise female fertility. At the present time, hysteroscopy, laparoscopy with chromopertubation and X-hysterosalpingography(X-HSG) are widely accepted screening procedures enabling the effective assessment of both tubal patency and uterine cavity. Nevertheless, consistent evidence supports the reliability of hysterosalpingo contrast sonography(Hy Co Sy) in uterine cavity and tubal patency investigation, as a part of the standard infertility work-up. This study was aimed at evaluating the pain and cause of pain as well as the incidence and duration of related side effects and complications of hysterosalpingo contrast sonography(Hy Co Sy) with Sono Vue in infertile patients.Methods: In this study, pain perception of 130 infertile women undergoing hysterosalpingo contrast sonography and X-hysterosalpingography was measured by means of an 11 point numeric rating scale and the Stacey score. Incidence and duration of side effects and late complications were also recorded. We looked for correlations between pain level and variables pertaining to the procedures.Results: The mean pain scores of 11 point numeric rating scale for Hy Co Sy was 3.43 ± 1.62 SD, and that was lower than 4.74±1.78 SD of HSG. The pain of Hy Co Sy was less than or equal to menstrual pain. Most of the patients(36/65 55.4%) rated Hy Co Sy as a non-painful to mild procedure, whereas 44.6%(29/65)women reported moderate pelvic pain. No patient experienced severe pelvic pain and required drug administration for pain relief. Only two patients(2/65, 3.1%) showed mild vomiting of vasovagal reactions that resolved without atropine administration. No severe vasovagal reactions or late complications were observed. Light vaginal bleeding and mild pelvic pain are the side effects of post operation and which disappear within a week. The median duration of Hy Co Sy of postoperative pain was(1.00±0.11)d, less than that of XHSG(3.00±0.13)d. Two groups of postoperative vaginal bleeding average duration were(3.00±0.13)d and(3.00±0.19)d,respectively. And there was no statistically significant difference between them(P > 0.05).The pain score was related with volume of contrast medium injected and the degree of tubal obstruction. However, there was no correlation between pain and volume of balloon catheter.Conclusions: Hy Co Sy is used as the initial step for the assessment of fallopian tube patency because it is a simple, safe, and well tolerated technique with a low risk of side effects and severe complications. At the same time it also has a certain therapeutic effect.