HyCoSy (Hysterosalpingo sonography), sometimes referred to as HyFoSy) is a tubal-patency test procedure being increasingly used instead of HSG (hysterosalpingogram – X-ray) to avoid subjecting patients to ionising radiation.

The efficacy of the HyCoSy procedure offers the opportunity to conduct a tubal patency examination on sub-fertile patients which is at least as cost effective if not better than the current HSG exam provided. HyCoSy has now been shown to incur less cost than HSG. It removes any unnecessary risks with the HSG exam associated with ionising radiation (no matter how small) and the IR(ME)R legislation (2000)* states that no person should carry out medical exposure if alternative techniques are available having the same objective but involving no or less exposure to ionising radiation. HyCoSy also offers an ultrasound assessment of the pelvis at the same time with the superior detection of intrauterine abnormalities.

The surroundings and staff competencies associated with HyCoSy may provide a more skillful and sympathetic examination at a time of uncertainty and high emotion for the patient. The HyCoSy procedure has been shown to be well tolerated with few side effects and no late complications. These factors along with lower pain scores, less discomfort and a quicker procedure time, help achieve improved patient satisfaction scores.  It has been suggested that HSG is out of date and has no place in modern infertility evaluation.

Setting up a HyCoSy service may require further training of either the Gynaecologist, Sonographer and/or Nurse in the placement of the catheter and the preparation and introduction of ExEm Foam Kit and the interpretation of the ultrasound images and a number of HyCoSy training courses are now available nationally (link to our courses?).

ExEm Foam Kit is nationally used for HyCoSy, available exclusively from de Smit Medical for the UK and Ireland.

*Department of Health. The Ionising Radiation (Medical Exposure) Regulations 2000. London: The Stationery Office, 2000.  http://www.legislation.gov.uk/uksi/2000/1059/regulation/6/made