Fertulity IVF
Fertulity IVF

Ultrasound Hysterosalpingography (HyCoSy / HyFoSy) Ultrasound Hysterosalpingography (HyCoSy / HyFoSy)

What Is Ultrasound Hysterosalpingography (HyCoSy / HyFoSy)?

HyCoSy (Hysterosalpingo-Contrast Sonography) or HyFoSy (Hysterosalpingo-Foam Sonography) is a modern, painless, and minimally invasive examination primarily used to assess fallopian tube patency through ultrasound imaging with the use of a special contrast foam agent (ExEm Foam®). It is considered one of the most important examinations in fertility assessment, as blockage or dysfunction of the fallopian tubes is one of the leading causes of infertility and accounts for a significant percentage of conception difficulties.

During the examination, the physician evaluates whether the fallopian tubes are patent, meaning whether they allow the normal passage of the egg and the transport of sperm toward it, enabling fertilization to occur. If blockage or reduced tubal patency is detected, the chances of natural conception may be directly affected. At the same time, the examination provides a general assessment of the uterine cavity and uterine anatomy, although this is not considered the primary purpose of the procedure. HyCoSy / HyFoSy is performed without radiation exposure, without the use of iodine, and without the discomfort associated with older methods such as Hysterosalpingography (HSG), offering a safe and reliable solution for modern fertility evaluation.

How Does HyCoSy Differ from Hysterosalpingography (HSG)?

Book A Consultation
Traditionally, the diagnosis of fallopian tube blockage was performed using Hysterosalpingography (HSG), an examination based on fluoroscopy and the use of iodine-based contrast dye. This method is often associated with discomfort or pain, involves exposure to radiation, and does not provide a comprehensive evaluation of all reproductive organs.

In contrast, HyCoSy / HyFoSy is a modern fallopian tube examination performed under ultrasound guidance, without radiation exposure and without the use of iodine. It is painless or causes only minimal discomfort, while allowing real-time assessment of fallopian tube patency. At the same time, it provides a comprehensive evaluation of the reproductive anatomy, including the myometrium, the external contour of the uterus, and the ovaries, with high diagnostic accuracy.

The ability to obtain immediate and reliable information makes HyCoSy / HyFoSy a particularly valuable tool in fertility assessment, facilitating fast and targeted decision-making regarding the next steps of the treatment approach.
Feature HyCoSy / HyFoSy Hysterosalpingography (HSG)
Examination Duration 15–20 minutes 30–45 minutes
Pain Level Mild or minimal discomfort Moderate to severe discomfort
Contrast Medium Contrast foam agent (ExEm Foam®) Iodine-based contrast dye
Imaging Method High-resolution ultrasound Fluoroscopy
Radiation Exposure None Present
Allergic Reactions Extremely rare Possible (due to iodine)
Recovery Time Immediate return to daily activities Recovery time may be required
Fallopian Tube Assessment Yes, in real time Yes
Uterine Evaluation Secondary, basic assessment Limited (mainly endometrial evaluation)

What Are the Advantages of HyCoSy

The HyCoSy examination offers numerous advantages and presents virtually no significant disadvantages.
Specifically:
Painless and bloodless examination, without the need for anesthesia or medication
No radiation exposure
Extremely rare allergic reactions due to the absence of iodine
Extremely rare allergic reactions due to the absence of iodine
Immediate return to daily activities with no recovery time required
Immediate return to daily activities with no recovery time required
Real-time information with immediate explanation and guidance from the physician

HyCoSy and Increased Chances of Pregnancy

Scientific evidence suggests that HyCoSy / HyFoSy may not only serve as a diagnostic examination but may also help improve the chances of natural conception. The passage of the contrast foam through the fallopian tubes may create a mechanical “tubal flushing” effect, helping remove minor blockages or adhesions that may not be visible on imaging examinations. A study by Engels et al. (2023), which evaluated pregnancy rates after hysterosalpingo-foam sonography (HyFoSy), showed that a significant percentage of women achieved spontaneous pregnancy during the first months following the examination, particularly in cases of unexplained infertility and shorter duration of conception attempts. This potential positive effect makes HyCoSy / HyFoSy not only a valuable tool for diagnosing fallopian tube patency, but also an examination that may practically contribute to improving fertility in selected cases.

Frequently asked questions about HyCoSy / HyFoSy

Is HyCoSy / HyFoSy painful?

No. Most women describe only mild discomfort, similar to light menstrual cramps. Unlike Hysterosalpingography (HSG), HyCoSy / HyFoSy does not require anesthesia during the examination or pain medication afterward.

How long does the examination take?

The examination lasts approximately 15–20 minutes in total. The procedure is performed in the doctor’s office and does not require hospitalization.

Are there any side effects?

In rare cases, mild spotting or slight discomfort may occur after the examination, but these symptoms usually resolve quickly. In certain cases, preventive antibiotics or mild pain relievers may be recommended.

What should I know before the examination?

The examination is performed after menstruation and once a negative pregnancy test has been confirmed.

When is HyCoSy not recommended?

HyCoSy is not recommended in cases of active infection, possible pregnancy, or insufficient information regarding the menstrual cycle.

Our Doctors

In an era where fertility requires knowledge, care, and substantial guidance, FertUlity is not an impersonal clinic. It is two people who look you in the eye and accompany you step by step on the journey you dream of.

Dr. Chrysostomos (Makis) Papadopoulos Obstetrician – Gynecologist, MD, PhDc, MIC I

See Full CV
Dr. Chrysostomos Papadopoulos - Specialist in Infertility, Endocrinology & Menopause in Athens

Dr. Maria Oikonomou Obstetrician – Gynecologist

See Full CV

The First Step Starts Now

You don’t need to have all the answers to begin.
All it takes is one first step, and a team that truly listens.
Book Your Consultation

FertulityThrough the Words of our Parents

100% genuine, public Google reviews.
Because every fertility journey begins with honesty and trust.

Why choose FertUlity?

Because every fertility journey deserves the right support.

At FertUlity, we provide science-based fertility care with a human approach.
We support every path, from fertility assessment and preservation to modern assisted reproduction.

Ready for the next step?

Contact Form

Learn More About IVF & Fertility

Knowledge brings confidence. At FertUlity, we share evidence-based information so you can make the right decisions about your fertility.
crossmenu