What is a HyCoSy?

HyCoSy is a nick-name for hystero-salpingo contrast sonography. It is a technique we use to check if your Fallopian tubes are patent. Some people call it a "Levovist" because that is the name of the contrast agent we use.

About 30% of cases of infertility are due to the woman's tubes being blocked. This can occur from previous pelvic infections, previous ectopic pregnancy or previous surgery. Tubal blockage prevents the egg from meeting the sperm, so conception cannot take place. If your doctor wants to test whether or not your tubes are working, there are several different choices of tests available.

Levovist contrast flowing out through the Fallopian tube.

HyCoSy refers to the test we perform with transvaginal ultrasound examination and a contrast agent called Levovist.

How is a HyCoSy done?

It must not be done when you are or could be pregnant, so it is best planned for the first half of your cycle, before day 14 when ovulation usually takes place.

You are asked to empty your bladder and to put on a gown in the bathroom. Then you can lie down while the sonographer covers you.

Transvaginal image of a left ectopic pregnancy.

Our doctors are all fully trained gynaecologists. The doctor introduces a speculum into the vagina. It feels like a Pap smear. Then he/she will slip a thin tube into the cervical canal and inflate a tiny balloon on the end to hold it in place. The speculum is removed and replaced by the trans-vaginal ultrasound transducer. A solution of saline is instilled to outline the endometrial cavity and then the special Levovist contrast agent is injected. The Levovist shows up as bright white sparkly fluid on ultrasound examination. Its path is followed up into the uterus and then (hopefully) out through the Fallopian tubes on each side.

We can also use colour Doppler imaging to demonstrate the presence of the contrast agent in the Fallopian tubes and spilling out over the ovaries on each side. If one or both tubes are not patent then this becomes obvious during the examination.

Why is HyCoSy more expensive?

Hydrosalpinx with Colour

The tubal patency studies may need special ultrasonic contrast fluid called Levovist. It is a sterile solution which has to be made up specially for each individual patient, immediately before use. It is the most expensive part of the procedure. The other options available to test tubal patency are laparoscopy and dye, done under general anaesthetic, or hystero-salpingo-graphy done with x-ray visualisation. These other tests are more uncomfortable and more expensive. You may wish to discuss these options with your doctor.

This proves tubal patency.

Will it be painful?

Sonohysterography does not required hospitalisation, anaesthetic or analgesia. Some women have some period-like pain during or shortly after the procedure. Tubal patency studies can cause a bit more cramping. We recommend you take a couple of Nurofen or Naprogesic beforehand.

Are there any risks?

A normal Fallopian tube with Levovist contrast and three dimensional reconstruction.

Some women feel a bit faint after the procedure, but after a rest, they recover. There is a risk of introducing infection, though this is extremely rare. If there is a chance that you already have a pelvic infection the procedure should be avoided because of the risk of it being exacerbated. Please talk to the doctor about your history before the procedure.

After the procedure?

We recommend that you sit and rest for 10 minutes or so after the test. We will explain the results to you. The report will be forwarded to your doctor. Your doctor will plan whether or not you need further treatment.