Diagnostic accuracy of hysterosalpingo-lidocaine-foam sonography combined with power Doppler (HyLiFoSy-PD) compared to laparoscopy and dye testing in tubal patency assessment in cases of infertility

Abstract Background Tubal patency testing is an essential part of female subfertility evaluation. Hysterosalpingogram less invasive and expensive compared to laparoscopy dye (LDT), i.e., laparoscopic chromopertubation. Hysterosalpingo-foam sonography (HyFoSy) uses commercial echogenic gel foam that easily visible on ultrasound assess the tubes. It offers a safer painful alternative HSG, with no radiation exposure. Hysterosalpingo-lidocaine-foam power Doppler (HyLiFoSy-PD) lidocaine-made as contrast medium. was postulated be easier detect ultrasound, hysterosalpingo-foam using other media it can also used whenever HyFoSy not available or relatively expensive. Methodology This prospective diagnostic accuracy study carried out between February 2018 2020 at Cairo Fetal Medicine Unit, Department Obstetrics Gynecology, University. One hundred twenty-two infertile patients, who were already scheduled for LDT their infertility work-up, consecutively recruited this study. The HyLiFoSy-PD (index test) performed 1 week before these patients. Using intrauterine pediatric Folley’s balloon catheter, 20 ml slowly infused intrauterine, while observing flow in both fallopian tubes grayscale transvaginal two-dimensional system. All patients then underwent (reference test). results those determine tubal assessment. We assessed procedure duration, associated pain, complications. Results Comparing 115 completed procedure, showed 98.1% sensitivity, 90% specificity, 99% positive predictive value, 81.8% negative 9.81 likelihood ratio, 0.02 ration, 97.4% overall assessment (odds ratio = 463.5 confidence interval 79.39–2706; P -value: 0.687). median duration 11 min. experienced some degree pain during 91 (79%) reported mild 24 (21%) moderate pain. Conclusion found accurate tool safe well-tolerated.