Hysterosalpingo-foam sonography, a less painful procedure for tubal patency testing during fertility workup compared with (serial) hysterosalpingography: a randomized controlled trial.

OBJECTIVE: To determine whether hysterosalpingo-foam sonography (HyFoSy) is a less painful first line tubal patency test than serial hysterosalpingography (HSG). DESIGN: A two-center, prospective, open-label, randomized, controlled trial. SETTING: University hospital and teaching hospital. PATIENT(S): 40 subfertile women, ages 18 to 41 years, with an indication for tubal patency testing as part of the fertility workup according to the Dutch Nederlandse Vereniging voor Obsteterie & Gynaecologie-guidelines. INTERVENTION(S): Tubal patency testing by HyFoSy versus serial HSG. MAIN OUTCOME MEASURE(S): Visual Analogue Scale (VAS) pain scores during tubal patency testing. RESULT(S): The median VAS score for pain perception during the HyFoSy procedure was 1.7 cm (interquartile range: 2.1) compared with 3.7 cm (interquartile range: 4.2) during HSG. The HyFoSy procedure also had a statistically significantly shorter procedure time compared with HSG, with a median of 5.0 minutes (interquartile range: 3.0) for HyFoSy versus 12.5 minutes (interquartile range: 16.0) for HSG. CONCLUSION(S): The HyFoSy procedure is a less painful and less time-consuming tubal patency test compared with HSG. CLINICAL TRIAL REGISTRATION NUMBER: Netherlands National Trial Register NTR3457.