HyCoSy (Hysterosalpingo-Contrast Sonography) is a modern, ultrasound-based procedure used to check whether the fallopian tubes are open (patent), which is a vital part of fertility investigations. A transvaginal ultrasound is first performed, followed by the gentle introduction of a sterile contrast fluid through a thin catheter inserted into the cervix. The contrast travels through the uterus and fallopian tubes, mimicking sperm movement, and real-time imaging shows whether the tubes are open. HyFoSy (Hysterosalpingo-Foam Sonography) is an advanced version of HyCoSy that uses a sterile foam containing microbubbles instead of saline, offering enhanced visibility and diagnostic clarity.
Tubal blockages may result from previous or undiagnosed chlamydia infections, a history of pelvic inflammatory disease (PID), complications from D&C procedures or IUD insertions, or rare congenital malformations of the uterus or tubes. The procedure is performed after menstruation ends (Day 5–6) and before ovulation, and if you wish to try for pregnancy in the same cycle, HyCoSy is considered safe and compatible with conception. Some women experience mild to moderate cramping, especially if the tubes are partially or fully blocked. It is recommended to take Paracetamol (1g) or Ibuprofen (400mg) about 30–60 minutes before the test, and mild discomfort may continue briefly but usually resolves the same day.
Routine antibiotics are not always necessary based on updated guidelines, and your doctor will provide personalised advice, especially if you have a history of pelvic infections, while you should inform us of any known allergies to antibiotics. Compared with HysteroSalpingoGram (HSG), HyCoSy and HyFoSy use ultrasound rather than X-ray, are generally better tolerated, allow real-time explanation, involve no radiation, and have comparable diagnostic accuracy. At Almond Blossoms, HyFoSy is preferred for its comfort and clarity. References: Yu J et al. Diagnostic efficacy of 3-D hysterosalpingo-contrast sonography in the detection of tubal occlusion. J Obstet Gynaecol Res. 2015;41(9):1418–25. Lim SL et al. A comparison of HyFoSy and HyCoSy in tubal patency assessment. Eur J Obstet Gynecol Reprod Biol. 2015;195:168–72.
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