الفهرس 
AnatomyOnly 14 pages are availabe for public view
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Abstract
The current trend for couples to defer childbirth to later ages has resulted in an increasing number of couples presenting with infertility problems. Women presenting with infertility undergo many laboratory tests and imaging studies to exclude endocrine disturbances ,congenital anomalies of the genital tract, uterine abnormality, and occlusion of the fallopian tubes. The latter is a common cause of infertility, found in up to 30% of women being evaluated for the inability to conceive.
Conventional HSG under fluoroscopy remains the most commonly used procedure to diagnose fallopian tube patency in women. However, conventional HSG exposes the reproductive organs of a potentially fertile woman to ionizing radiation. Furthermore, conventional HSG provides a limited evaluation of other causes of infertility, such as congenital uterine malformation, myometrial abnormalities (adenomyosis, leiomyomas), and extrauterine diseases (endometriosis, adhesions, pelvic infection, adnexal disease).
Initial sonographic examination of infertile patients especially if followed by HyCoSy, could avoid HSG in patients with patent Fallopian tubes.
Sonohysterography using intrauterine infusion of saline solution is known to provide accurate delineation of the endometrial cavity has also been proposed for the analysis of Fallopian tube patency.
Hysterosalpingography - contrast-sonography (HyCoSy) performed either by 2D or 3D US is superior screening method for evaluation of infertile patients. Screening positives should be directed to operative hysteroscopy and/or laparoscopy.
In case of sonographically normal findings, i.e. free tubal patency, the patient could spare more invasive diagnostic techniques such as chromo-laparoscopy and time would be gained for further steps in sterility diagnosis and therapy.
Although 3D ultrasound scan machine is expensive and training is required, its cost-effectiveness compares favorably with laparoscopy the most expensive and invasive option.
HyCoSy also has several advantages over HSG including simplicity, decreased cost, minimal invasiveness, lack of ionizing radiation, and a high level of diagnostic accuracy with an ability to more accurately characterize masses within the endometrial cavity.
HyCoSy should be suitable as an outpatient procedure for early tubal diagnosis of sterility.