Hysterosalpingo contrast sonography for the evaluation of the tubal factor in infertility investigation: Review of literature

Tubal evaluation is an integral part of any infertility work-up. Existing modalities include laparoscopy and dye - the current gold standard, and hysterosalpingography (HSG); both are effective methods with significant drawbacks. Hysterosalpingo contrast sonography (HyCoSy) has been compared favorably with HSG in the literature, and has received growing attention as a minimally invasive screening test. Many clinical trials report it to be as accurate as HSG in evaluating tubal function, while maintaining the advantages of ultrasonography as a safe and well-tolerated imaging modality. Others emphasize its superiority in demonstrating ovarian morphology, which is also pertinent to infertility investigation. This review of the literature will summarise the existing data on hysterosalpingo contrast sonography and compare it to existing modalities in terms of accuracy, tolerability, and cost-effectiveness in order to determine whether it can practically replace HSG as a primary screening tool.