Hysterosalpingoconstrastsonography (HyCoSy)

What are the common reasons for having this examination?

• Investigation of sub-fertility
• Recurrent miscarriage

You should not have the procedure if you are pregnant or may be pregnant at the time of the examination or you have acute pelvic infection or unexplained pelvic tenderness which may be due to pelvic inflammatory disease.

This technique is used to detect abnormalities of the uterus, endometrium and fallopian tubes or tubal blockage. Essentially a small amount of fluid is injected into the uterus through a fine tube. This procedure is a safer alternative to the conventional hysterosalpingogram (HSG) which uses X-rays. There is no radiation or iodinated contrast material used.

Will I need an anaesthetic?

No anaesthesia is required for this procedure. It is associated with some discomfort although HyCoSy is probably less uncomfortable than HSG as the fluid injected (saline or the sugar solution, Levovist ) is less irritant than the radio-opaque dye used in HSG. Saline is used where information about the uterus only is required and for most procedures assessing tubal patency, however where difficulty is experienced in demonstrating tubal patency Levovist is used. Levovist is a very expensive solution (around $100) compared to saline which costs only a few cents.

What preparation is required for this procedure?

The procedure is performed in the first 10 days of the menstrual cycle after bleeding has ceased. If you have irregular or infrequent periods the timing should be discussed with your doctor or with us prior to making a booking.

In general it is not necessary to take antibiotics before the procedure but these may need to be considered in special circumstances. You should discuss the need for antibiotics with your referring doctor who will write a prescription for the antibiotics which need to be taken 2 hours prior to attendance for the procedure.

How is the procedure performed?

Generally, if you have not had a pelvic scan at Women’s Imaging Services in the last 6 months you will be booked for a preliminary pelvic scan. Following this scan a booking will be made for the procedure itself. A half hour appointment is required for the procedure.

It is best to contact us to make a booking to facilitate correct timing for the procedure.

On the day of the procedure a transabdominal ultrasound of the pelvis may be performed with or without a transvaginal ultrasound immediately prior to the procedure. Before the procedure commences your bladder will need to be emptied. For the procedure itself your legs will be placed in stirrups (the lithotomy position) and a vaginal speculum will be placed in the vagina. The cervix will be cleaned with Betadine antiseptic solution and a fine (2 mm) plastic tube passed through the cervix into the uterus. A small balloon on the catheter is inflated to keep the catheter in place. The speculum is removed and a vaginal ultrasound scan is then performed as the saline/Levovist is injected. You will be advised of the findings as the procedure is performed. 

Will I need analgesia after the procedure?

You may require a single dose of simple analgesia eg. Panadol following the procedure.

What will the procedures cost me?

Please go to cost and fee structure for more information.
If the use of Levovist is required there will be a further cost to cover this item.