Overview of the procedure

HyFoSy/HyCoSy involving ExEm foam gel or sonographic technique is an ultrasound-based method for locating fallopian tube anomalies or tubal obstructions. Compared to the conventional hysterosalpingogram (HSG) and laparoscopy and dye test, it is a safer method of determining tubal patency.

Anomalies of the fallopian tubes cause up to 40% of female subfertility. A typical pelvic scan does not reveal normal fallopian tubes, but the strong echoes created by ExEm foam gel can be utilised to show the tubes. This process was previously referred to as HyCoSy.

Hyfosy/Hycosy has many benefits as follows:

  • Neither radiation nor iodinated contrast medium is used.
  • Since the fluid used in HyCoSy injections causes less irritability than the dyes used in HSG, the pain is less.
  • By doing so, laparoscopy's accompanying anaesthesia and hospitalisation can be avoided.
  • Using ultrasound technology, various pelvic structures may be evaluated.

About the test

First, a standard pelvic ultrasound is scheduled, especially if you haven't had one within six months of your HyCoSy procedure. This is crucial because it makes it easier to spot circumstances in which HyCoSy might not work. HyFoSy may not have been carried out if an anomaly is found that necessitates additional evaluation by your doctor.

Since a complete bladder is not required for the treatment, the bladder is emptied immediately before it begins. To evaluate the pelvic anatomy, a vaginal ultrasound scan is performed initially. The following procedure involves inserting a 2mm fine, sterilised plastic thread via the cervix. This little inflatable catheter at the head is inflated once the tip is within the uterine cavity to hold the catheter there. Once more, a vaginal probe is used after removing the speculum. A scan is conducted as the ExEm foam gel is administered through the catheter. The ExEm foam gel visualises the whole tube and causes spills around it due to the vivid echoes it produces.

The reproductive organs are considered patent when both sides can observe spillage. However, it can be assumed that they are closed when spillage is absent since the uterus's occasional spasms might momentarily shut the openings of the fallopian tubes. If such a circumstance occurs, your referring physician will arrange further tubal patency tests.

Risk factors

Vasovagal responses, pelvic discomfort, pelvic pain, fever, peritonitis, and bleeding, in particular, have been documented; however, it is uncertain how often these adverse effects are in a broad population of women having HyCoSy.

Preparing for the test

Your bladder doesn't have to be full. After having an abdominal scan, you might be told to empty your bladder and transfer into a robe in the bathroom. When you are lying on the bed, your legs will be at a lesser level where they may comfortably rest. Transvaginal ultrasound is the next stage, during which medical professionals look at your uterus, endometrial, and ovaries to assess their size, shape, and appearance.

One of the professionals will then completely explain the procedure to you. An extremely thin (2mm) tubing, or catheter, is inserted through the cervix into the upper vagina after it has been cleaned with antiseptic. The transvaginal ultrasonography probe is then inserted in its place once the speculum is taken off. A little bubble on the tube is inflated to maintain the catheter in place. During the first stage of the test, regular saline is injected into the catheter to get information about the inside of the uterus. The subsequent injection's ultrasound image, which shows tiny bubbles, is very white. If the ovaries are wide open, the specialists may see fluid pouring through the oviduct and spilling around them.

What should you expect?

A thorough report is given to the doctor who referred you, and doctors can discuss the results with you during the test day. Most women can drive after surgery. However, having someone accessible to take you home might be useful if you feel dizziness or cramps, as some women do. There may be mild cramps and watery vaginal discharge for up to 24 hours. There may occasionally be a little amount of blood or spotting. 

Possible Outcomes

Most women only experience little discomfort. Others could get menstrual-like cramping while undergoing the operation. Take two pills of an anti-inflammatory drug, such as Nurofen or Brufen, one hour before the surgery to reduce this. Panadol or Panadeine can be substituted for anti-inflammatory drugs by women who cannot take them.

When to see a doctor?

Your doctor could recommend HyCoSy in the following situations:

  • To evaluate infertility,
  • Before infertility treatment

If you face any of the abovementioned conditions, you can reach the Apollo Fertility Centre, RR Nagar. For an appointment, you can also make a call to 1860 500 4424.


This test is carried out in the form of a fertility evaluation. The initial 10 days of a menstrual cycle are ideal for doing the research. After the bleeding starts, it should end in 24 hours. If you suspect a pelvic infection, you must not perform it. First, please speak with your doctor.

1. What should I anticipate from a HyCoSy?

In HyCoSy, the uterus and ovaries are first evaluated with a baseline ultrasound examination utilising a vaginal probe, and the cervix is then seen through a speculum. Similar to a smear test, this. The speculum is withdrawn after placing a small plastic catheter into the womb's neck.

2. How long does the test take?

The test takes about 45-60 minutes to complete.

3. When should it not be done?

It should not be done while you are or may be pregnant; thus, it is better to schedule it before days 12 to 14, when ovulation often occurs in the first part of your cycle.

4. Who qualifies for the test?

Women with abnormalities in the uterus and who have complications in pregnancy should do this test.

5. Are there any risks in this test?

There are minimal risks in this test. You might feel uneasiness and pain during the assessment.

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