Sonohysterosalpingography: Comparison of foam and saline solution

J Clin Ultrasound. 2017 Feb;45(2):67-71. doi: 10.1002/jcu.22412. Epub 2016 Oct 18.


Purpose: To compare sonohysterosalpingography (sono-HSG) with foam instillation (HyFoSy) versus saline solution (HyCoSy) in the evaluation of tubal patency.

Methods: We prospectively enrolled 37 infertile women, scheduled for laparoscopy. The women were randomized into two groups: HyFoSy (group I) and HyCoSy (group II). The patients of both groups underwent laparoscopy with dye test. We assessed the diagnostic performance (sensitivity, specificity, and overall accuracy) of HyFoSy and HyCoSy, compared with laparoscopy and dye test, in the assessment of tubal patency.

Results: Sono-HSG findings in tubal patency assessment obtained in the HyFoSy group were concordant with laparoscopic results in 94.4% of cases, with a sensitivity of 87.5% and a specificity of 100%, whereas in the HyCoSy group, concordance occurred in only 57.8% of examinations, with a sensitivity of 50% and a specificity of 66.6%.

Conclusions: HyFoSy allows a more accurate diagnosis of tubal patency compared with HyCoSy. © 2016 Wiley Periodicals, Inc. J Clin Ultrasound 45:67-71, 2017.

Keywords: HyCoSy; HyFoSy; foam; gynecology; infertility; saline; sonohysterosalpingography; tubal patency.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Contrast Media
  • Fallopian Tube Diseases / complications
  • Fallopian Tube Diseases / diagnostic imaging*
  • Fallopian Tube Patency Tests
  • Fallopian Tubes / diagnostic imaging*
  • Female
  • Humans
  • Infertility, Female / diagnostic imaging
  • Infertility, Female / etiology*
  • Laparoscopy
  • Sensitivity and Specificity
  • Sodium Chloride
  • Ultrasonography
  • Uterus / diagnostic imaging*
  • Vaginal Creams, Foams, and Jellies


  • Contrast Media
  • Vaginal Creams, Foams, and Jellies
  • Sodium Chloride