Pain and side effects associated with 4-dimensional hysterosalpingo-contrast sonography for evaluating of the fallopian tubes patency

Abstract

4-Dimensional hysterosalpingo-contrast sonography (4 D HyCoSy) using SonoVue is regarded as a really good option available for evaluating fallopian tubal patency. This study was designed to assess the pain and adverse effects incurred by women undergoing 4 D HyCoSy. Through evaluating the pelvic pain immediately after 4 D HyCoSy and 30 min after 4 D HyCoSy, the circumstances of the pain relief was also observed. The predictive factors of pain were assessed simultaneously. 827 consecutive women as part of infertility evaluation were included. The pain experienced was then assessed on a 10-cm visual analogue scale (VAS). Each patient was questioned to rate the pain at two different points of time (T1, immediately after 4 D HyCoSy; T2, 30 min after 4 D HyCoSy). 818/827 (98.9%) patients completed the procedure. Pain was experienced by 757/818 (92.5%) of subjects. 30 min after HyCoSy procedure, only 0.5% (4/818) patients feel severe pelvic pain and after 15-30 minutes of rest, these patients were relieved of pain. Age, cycle length, duration of menses, and duration of infertility were not significantly correlated with pain associated with 4 D HyCoSy as assessed by VAS. Women with tubal obstruction experienced a significant increase in 4 D HyCoSy-associated pain. There were significant differences in the degree of pain between different tubal patency (p <0.01). Overall, 4 D HyCoSy, a user-friendly, multidimensional technology, has the advantage of real-time, dynamic, well tolerated, and low serious complications, which make it a good way for evaluating fallopian tubal patency. The technique aids in making choices concerning further procedures for the diagnosis and treatment of infertility. Most of women experience pain associated with the procedure and 30 minute period of observation is useful.

Keywords:

• 4-dimensional
• hysterosalpingo-contrast sonograph
• pain
• tubal patency

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was supported by Six Talent Project of Jiangsu Province, China (Grant no. 2014-WSN-016), Jiangsu Planned Projects for Postdoctoral Research (Grant no. 1501003B), Research Foundation of Jiangsu provincial commission of health and family planning (Grant No. LGY2016013) and Jiangsu Provincial Medical Youth Talent (Grant No. QNRC2016643).The authors would like to thank all participating women and the Division of Reproductive Endocrinology and Infertility in the Department of Obstetrics and Gynecology at the Affiliated Hospital of Nanjing University of Chinese Medicine.