Ultrasound Scan

This technique involves the use of fluid to distend the uterus (womb) coupled with high-resolution transvaginal (internal) scan. A standard speculum is inserted into the vagina and a fine catheter (tube) is gently fed through the neck of the womb and placed into the uterine cavity. The speculum is then removed, an ultrasound internal probe inserted and fluid injected into the womb under direct ultrasound observation.

SIS allows tremendous diagnostic enhancement with a relatively simple and well-tolerated outpatient procedure. It is easily and rapidly performed in the overwhelming majority of patients and virtually devoid of complications.
SIS provides a degree of image magnification similar to performing ultrasound through a microscope. Structures that would not be appreciated with the naked eye can easily be identified through enhanced ultrasonography performed by a trained operator.

Assessment of the endometrial cavity and thickness is very accurate. The need for invasive procedures such as biopsy (taking a sample of tissue), hysteroscopy (inserting a telescope into the uterus through the neck of the womb) and dilatation & curettage is greatly reduced in women with abnormal bleeding. SIS can be used as an investigation of infertility and recurrent miscarriage, and to further study the presence of a mass (fibroid or polyp) in the uterine cavity.

The report of the scan highlighting the findings is available straightaway and will be sent to the referring doctor and a copy to the patient.

HyCoSy consists of a transvaginal (internal) ultrasound scan during which air and saline (sterile water-like fluid) or a solution of D-galactose (sugar-like solution) is infused into the uterine cavity (womb) and observed to flow along the fallopian tubes in order to investigate their patency. The echoes (images) produced by the contrast allow visualisation of the tubes. The addition of colour Doppler to the standard ultrasound scan further improves the quality and accuracy of the image.

HyCoSy has increasingly been used instead of other more invasive methods such as hysterosalpingography (HSG) and laparoscopy & dye test. Many fertility clinicians consider HyCoSy the first line investigation to assess the status of the tubes, especially in women who do not suffer from pelvic pain or do not have a history of previous pelvic infection or repeated surgical operations. HyCoSy is a reliable, convenient and safe outpatient test. Of note, other pelvic organs (uterus and ovaries) can be visualised at the same time by this dynamic ultrasound examination, thus reducing the number of tests in the investigation of infertility.

This technique can cause mild lower abdominal discomfort, especially if the fallopian tubes are damaged or blocked and if there are adhesions in the pelvis. Due to the small risk of spreading infections to the pelvis, it is recommended to take antibiotics for 5 days.

The information about the status of the fallopian tubes is available to the patient straightaway after the test. In the context of a "one-stop fertility clinic" it will be possible to discuss further management accordingly. The report of the scan including details of the HyCoSy test will be sent to the referring doctor and a copy to the patient.