Satisfaction of Hysterosalpingo-Foam Sonography

Tubal patency testing is an essential component of the fertility work-up. Worldwide, infertility currently affects 5-15% of couples. Tubal occlusion is one of the leading causes of female infertility, accounting for approximately 26% of cases.

Assessment of tubal patency is crucial for diagnosing tubal obstruction before initiating fertility treatment, including intrauterine insemination (IUI) or in vitro fertilization (IVF). It is also important for documenting the success of tubal recanalization following tubal reconstructive surgery. Furthermore, tubal patency assessment plays a key role in fertility counseling for women.

Laparoscopy with chromopertubation has long been considered the gold standard for evaluating tubal patency; however, its main limitation is its invasive nature. Hysterosalpingography (HSG) was the first non-surgical alternative developed for tubal patency testing. Potential adverse effects include infection, allergic reactions to iodinated contrast media, vasovagal reactions related to procedural pain, and uterine or cervical perforation. In addition, HSG exposes patients to ionizing radiation, with an estimated dose of approximately 5 mGy per examination.

HyFoSy can therefore be incorporated into the routine fertility assessment following a pelvic ultrasound examination. Patients are placed in the Trendelenburg position, after which a pelvic examination is performed to insert the catheter and inject the contrast medium. This allows simultaneous evaluation of the uterine cavity, tubal patency, and ovaries during a single, radiation-free procedure.

In this prospective study, the investigators aim to expand upon these findings by investigating several aspects of the patient experience that remain poorly described in the literature, including :

• the quality of information provided before the examination
• patients' overall experience and pre-procedural anxiety
• the specific stages of the procedure associated with pain
• the relationships between patients' experiences, their individual characteristics, and their healthcare pathways

Inclusion criteria

• Provided verbal informed consent after receiving full information about the study procedures
• Women
• Aged 18 years or older
• Attending the fertility medicine unit and undergoing a HyFoSy ultrasound examination
• Affiliated with, or covered by, a social security health insurance scheme

Exclusion criteria

• Pregnant women
• Women who are breastfeeding or in the postpartum period
• Non-emancipated minors
• Adults under legal protection (guardianship, curatorship, or judicial protection)
• Adults unable to provide informed consent
• Individuals deprived of liberty by judicial or administrative decision
• Individuals receiving involuntary psychiatric care
• Individuals who have declined participation in the study