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 is less invasive and less expensive compared to laparoscopy and dye testing (LDT), i.e., laparoscopic chromopertubation. Hysterosalpingo-foam sonography (HyFoSy) uses commercial echo...
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| Format: | Article |
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SpringerOpen
2022-12-01
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| Series: | Middle East Fertility Society Journal |
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| Online Access: | https://doi.org/10.1186/s43043-022-00125-3 |
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| author | Marwa F. Sharaf Ibrahim Fawzy Islam T. Elkhateb Yassin Elmahgoub Omaima Idris Mona Aboulghar |
| author_facet | Marwa F. Sharaf Ibrahim Fawzy Islam T. Elkhateb Yassin Elmahgoub Omaima Idris Mona Aboulghar |
| author_sort | Marwa F. Sharaf |
| collection | DOAJ |
| description | Abstract Background Tubal patency testing is an essential part of female subfertility evaluation. Hysterosalpingogram is less invasive and less expensive compared to laparoscopy and dye testing (LDT), i.e., laparoscopic chromopertubation. Hysterosalpingo-foam sonography (HyFoSy) uses commercial echogenic gel foam that is easily visible on ultrasound to assess the tubes. It offers a safer and less painful alternative to HSG, with no radiation exposure. Hysterosalpingo-lidocaine-foam sonography with power Doppler (HyLiFoSy-PD) uses lidocaine-made gel foam as a contrast medium. It was postulated to as to be less painful and easier to detect on ultrasound, compared with hysterosalpingo-foam sonography using other contrast media and that it can also be used whenever the commercial gel used with HyFoSy is not available or is relatively expensive. Methodology This prospective diagnostic accuracy study was carried out between February 2018 and 2020 at the Cairo Fetal Medicine Unit, Department of Obstetrics and Gynecology, Cairo University. One hundred twenty-two infertile patients, who were already scheduled for LDT as a part of their infertility work-up, were consecutively recruited for this study. The HyLiFoSy-PD (index test) was performed 1 week before the scheduled LDT for these patients. Using an intrauterine pediatric Folley’s balloon catheter, 20 ml of lidocaine-made gel foam was slowly infused intrauterine, while observing their flow in both fallopian tubes using a grayscale and power Doppler transvaginal two-dimensional ultrasound system. All patients then underwent LDT (reference test). The results of HyLiFoSy-PD were compared with those of LDT to determine the accuracy of HyLiFoSy-PD in tubal patency assessment. We also assessed the procedure duration, associated pain, and other complications. Results Comparing HyLiFoSy-PD with LDT in the 115 patients who completed the procedure, results showed 98.1% sensitivity, 90% specificity, 99% positive predictive value, 81.8% negative predictive value, 9.81 positive likelihood ratio, 0.02 negative likelihood ration, and 97.4% overall accuracy in the assessment of tubal patency (odds ratio = 463.5 with confidence interval = 79.39–2706; P-value: 0.687). The median procedure duration was 11 min. All patients experienced some degree of pain during the procedure with 91 patients (79%) reported mild pain and 24 patients (21%) reported moderate pain. Conclusion HyLiFoSy-PD was found to be an accurate tool in tubal patency assessment. It was also found to be safe and well-tolerated. |
| first_indexed | 2024-04-11T05:10:10Z |
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| id | doaj.art-db8ee444f95e4de1b1e565385e42a552 |
| institution | Directory Open Access Journal |
| issn | 2090-3251 |
| language | English |
| last_indexed | 2024-04-11T05:10:10Z |
| publishDate | 2022-12-01 |
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| series | Middle East Fertility Society Journal |
| spelling | doaj.art-db8ee444f95e4de1b1e565385e42a5522022-12-25T12:05:48ZengSpringerOpenMiddle East Fertility Society Journal2090-32512022-12-012711910.1186/s43043-022-00125-3Diagnostic 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 infertilityMarwa F. Sharaf0Ibrahim Fawzy1Islam T. Elkhateb2Yassin Elmahgoub3Omaima Idris4Mona Aboulghar5University Department of Obstetrics & Gynecology, Kasr Alainy Hospital, Cairo UniversityUniversity Department of Obstetrics & Gynecology, Kasr Alainy Hospital, Cairo UniversityUniversity Department of Obstetrics & Gynecology, School of Medicine, New Giza University (NGU)School of Medicine, New Giza University (NGU)University Department of Obstetrics & Gynecology, Kasr Alainy Hospital, Cairo UniversityUniversity Department of Obstetrics & Gynecology, Kasr Alainy Hospital, Cairo UniversityAbstract Background Tubal patency testing is an essential part of female subfertility evaluation. Hysterosalpingogram is less invasive and less expensive compared to laparoscopy and dye testing (LDT), i.e., laparoscopic chromopertubation. Hysterosalpingo-foam sonography (HyFoSy) uses commercial echogenic gel foam that is easily visible on ultrasound to assess the tubes. It offers a safer and less painful alternative to HSG, with no radiation exposure. Hysterosalpingo-lidocaine-foam sonography with power Doppler (HyLiFoSy-PD) uses lidocaine-made gel foam as a contrast medium. It was postulated to as to be less painful and easier to detect on ultrasound, compared with hysterosalpingo-foam sonography using other contrast media and that it can also be used whenever the commercial gel used with HyFoSy is not available or is relatively expensive. Methodology This prospective diagnostic accuracy study was carried out between February 2018 and 2020 at the Cairo Fetal Medicine Unit, Department of Obstetrics and Gynecology, Cairo University. One hundred twenty-two infertile patients, who were already scheduled for LDT as a part of their infertility work-up, were consecutively recruited for this study. The HyLiFoSy-PD (index test) was performed 1 week before the scheduled LDT for these patients. Using an intrauterine pediatric Folley’s balloon catheter, 20 ml of lidocaine-made gel foam was slowly infused intrauterine, while observing their flow in both fallopian tubes using a grayscale and power Doppler transvaginal two-dimensional ultrasound system. All patients then underwent LDT (reference test). The results of HyLiFoSy-PD were compared with those of LDT to determine the accuracy of HyLiFoSy-PD in tubal patency assessment. We also assessed the procedure duration, associated pain, and other complications. Results Comparing HyLiFoSy-PD with LDT in the 115 patients who completed the procedure, results showed 98.1% sensitivity, 90% specificity, 99% positive predictive value, 81.8% negative predictive value, 9.81 positive likelihood ratio, 0.02 negative likelihood ration, and 97.4% overall accuracy in the assessment of tubal patency (odds ratio = 463.5 with confidence interval = 79.39–2706; P-value: 0.687). The median procedure duration was 11 min. All patients experienced some degree of pain during the procedure with 91 patients (79%) reported mild pain and 24 patients (21%) reported moderate pain. Conclusion HyLiFoSy-PD was found to be an accurate tool in tubal patency assessment. It was also found to be safe and well-tolerated.https://doi.org/10.1186/s43043-022-00125-3UltrasoundInfertilityFallopian tube patency testsContrast radiographyLidocaineLaparoscopy |
| spellingShingle | Marwa F. Sharaf Ibrahim Fawzy Islam T. Elkhateb Yassin Elmahgoub Omaima Idris Mona Aboulghar 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 Middle East Fertility Society Journal Ultrasound Infertility Fallopian tube patency tests Contrast radiography Lidocaine Laparoscopy |
| title | 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 |
| title_full | 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 |
| title_fullStr | 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 |
| title_full_unstemmed | 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 |
| title_short | 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 |
| title_sort | 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 |
| topic | Ultrasound Infertility Fallopian tube patency tests Contrast radiography Lidocaine Laparoscopy |
| url | https://doi.org/10.1186/s43043-022-00125-3 |
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