TY - JOUR
T1 - Evaluating Fallopian Tube Patency
T2 - What the Radiologist Needs to Know
AU - Grigovich, Maria
AU - Kacharia, Vidhi S.
AU - Bharwani, Nishat
AU - Hemingway, Anne
AU - Mijatovic, Velja
AU - Rodgers, Shuchi K.
N1 - Publisher Copyright: ©RSNA, 2021.
PY - 2021/10/1
Y1 - 2021/10/1
N2 - Impaired tubal patency accounts for up to 35% of cases of subfer-tility and infertility. Hysterosalpingography (HSG) or hysterosal-pingo-contrast sonography (HyCoSy) represents a first-line test in evaluating fallopian tube patency. Despite the association of HSG with ionizing radiation, HSG is a reference standard in assessing fallopian tube patency and tubal conditions such as tubal occlusion, salpingitis isthmica nodosa, and hydrosalpinx. HSG is widely available and utilizes either a water-soluble contrast medium (WSCM) or an oil-soluble contrast medium (OSCM). Compared with WSCM, HSG with OSCM results in a higher incidence of non–in vitro fertilization pregnancies and, therefore, may be pre-ferred in women younger than 38 years with unexplained subfer-tility. HSG may also be helpful in assessment after sterilization or before fallopian tube recanalization. US-based tubal tests are free of ionizing radiation and include HyCoSy, with either air-saline or microbubble US contrast material, and hysterosalpingo-foam sonography (HyFoSy), a tubal patency test that utilizes a gel foam. A comprehensive US infertility evaluation of the pelvis and fallopian tubes can be achieved in one setting by adding coronal three-dimensional imaging of the uterus, saline infusion sonohysterogra-phy, and HyCoSy or HyFoSy to routine pelvic US. MR HSG and virtual CT HSG also depict tubal patency and uterine and adnexal pathologic conditions and may be considered in select patients. While laparoscopic chromopertubation remains the standard for tubal patency evaluation, its disadvantages are its invasiveness and cost. Knowledge of the different fallopian tube tests and radiologic appearance of normal and abnormal fallopian tubes results in fewer pitfalls, accurate interpretation, and optimal patient care.
AB - Impaired tubal patency accounts for up to 35% of cases of subfer-tility and infertility. Hysterosalpingography (HSG) or hysterosal-pingo-contrast sonography (HyCoSy) represents a first-line test in evaluating fallopian tube patency. Despite the association of HSG with ionizing radiation, HSG is a reference standard in assessing fallopian tube patency and tubal conditions such as tubal occlusion, salpingitis isthmica nodosa, and hydrosalpinx. HSG is widely available and utilizes either a water-soluble contrast medium (WSCM) or an oil-soluble contrast medium (OSCM). Compared with WSCM, HSG with OSCM results in a higher incidence of non–in vitro fertilization pregnancies and, therefore, may be pre-ferred in women younger than 38 years with unexplained subfer-tility. HSG may also be helpful in assessment after sterilization or before fallopian tube recanalization. US-based tubal tests are free of ionizing radiation and include HyCoSy, with either air-saline or microbubble US contrast material, and hysterosalpingo-foam sonography (HyFoSy), a tubal patency test that utilizes a gel foam. A comprehensive US infertility evaluation of the pelvis and fallopian tubes can be achieved in one setting by adding coronal three-dimensional imaging of the uterus, saline infusion sonohysterogra-phy, and HyCoSy or HyFoSy to routine pelvic US. MR HSG and virtual CT HSG also depict tubal patency and uterine and adnexal pathologic conditions and may be considered in select patients. While laparoscopic chromopertubation remains the standard for tubal patency evaluation, its disadvantages are its invasiveness and cost. Knowledge of the different fallopian tube tests and radiologic appearance of normal and abnormal fallopian tubes results in fewer pitfalls, accurate interpretation, and optimal patient care.
UR - http://www.scopus.com/inward/record.url?scp=85117556454&partnerID=8YFLogxK
U2 - https://doi.org/10.1148/rg.2021210033
DO - https://doi.org/10.1148/rg.2021210033
M3 - Article
C2 - 34597232
SN - 1527-1323
VL - 41
SP - 1876
EP - 1896
JO - Radiographics : a review publication of the Radiological Society of North America, Inc
JF - Radiographics : a review publication of the Radiological Society of North America, Inc
IS - 6
ER -