E2497. Hystero-Salpingo-Contrast-Sonography: The Who, What, Where, When, and How
  1. Tiffany Han; University of California - San Francisco
  2. Hailey Choi; University of California - San Francisco
  3. Liina Poder; University of California - San Francisco
  4. Dorothy Shum; University of California - San Francisco
Evaluation of the uterus, endometrial cavity, ovaries and fallopian tube patency is an important initial steps for women undergoing an infertility workup. Many sites use a multi-step multi-modality approach, using transvaginal ultrasound, saline infusion sonohysterography (SIS), and hysterosalpingography (HSG) or hysterolaparoscopy (HLC). This process usually requires two separate examinations, over two independent appointments and possibly at different sites due to sonohysterograms being performed in an ultrasound laboratory, HSG requiring a room equipped with fluoroscopy and exposure to radiation, or HLC which is performed in an operating room as the patient is under general anesthesia. Adding to the inconvenience, the patient experience is negatively impacted because of the discomfort caused by endocervical cannulation and distention of the endometrial cavity. We aim to discuss the benefits of a more streamlined approach to evaluating female reproductive anatomy and function using Hystero-Salpingo-Contrast-Sonography (HyCoSy). This method allows both detailed visualization of uterine and adnexal anatomy, as well as evaluation of tubal patency in one setting by introducing sonographic-enhancing positive-contrast fluid into the endometrial cavity and within the fallopian tubes. The benefit of using this method is reducing inconvenience, particularly patients’ time and discomfort, and eliminating unnecessary exposure to radiation. It is also an effective and fairly inexpensive screening tool with high diagnostic accuracy when compared to HSG and laparoscopic dye perturbation.

Educational Goals / Teaching Points
Our educational goals through this exhibit is to familiarize radiologists with what HyCoSy is, how it is performed, diagnostic accuracy of the examination, patient experience data, examples of normal and abnormal, and tips and tricks to optimizing quality as this is currently an underutilized examination.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
We will discuss Hystero-Salpingo-Contrast-Sonography and show images demonstrating normal and abnormal exams of the uterine cavity and fallopian tubes.

We also hope to offer guidance on how radiologists can implement HyCoSy in their practice and enhance collaboration with our Reproductive Endocrinologist colleagues.