Small-vessel vasculitis: a potential rare adverse event following hysterosalpingo-foam sonography (HyFoSy)
Diagnostic imaging plays a pivotal role in both diagnosis and treatment of infertility in an assisted reproduction setting. In the fertility workup of a couple, the evaluation of the fallopian tubes stands as one of the cornerstones in the preliminary investigative process. Indeed, tubal pathology a...
| Autores: | , , , , , , , , |
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| Tipo de recurso: | artículo |
| Estado: | Versión publicada |
| Fecha de publicación: | 2024 |
| País: | España |
| Institución: | Universidad de Sevilla (US) |
| Repositorio: | idUS. Depósito de Investigación de la Universidad de Sevilla |
| OAI Identifier: | oai:idus.us.es:11441/178732 |
| Acceso en línea: | https://hdl.handle.net/11441/178732 https://doi.org/10.21037/qims-24-695 |
| Access Level: | acceso abierto |
| Sumario: | Diagnostic imaging plays a pivotal role in both diagnosis and treatment of infertility in an assisted reproduction setting. In the fertility workup of a couple, the evaluation of the fallopian tubes stands as one of the cornerstones in the preliminary investigative process. Indeed, tubal pathology accounts for reproductive dysfunction in approximately 20% of couples. The most common causes of tubal dysfunction are pelvic inflammatory disease, endometriosis and adhesions from previous surgery. Traditionally, the gold standard technique for tubal evaluation has been laparoscopy with chromopertubation (LC), but due to its invasive and costly nature, it was replaced for decades by hysterosalpingography (HSG), as a less invasive first-line alternative. Nevertheless, HSG involves irradiation of the female pelvis and exposure to iodinated contrast media, linked to potentially severe adverse reactions. Furthermore, it can be associated to discomfort and pain and requires appropriate equipment and facilities. Given this context, hysterosalpingo-contrast sonography (HyCosy) emerged as an alternative, avoiding the aforementioned risks and allowing for the use of either contrast media or saline solution. The accuracy of HyCoSy is comparable to that of HSG and LC, recognized as reference standards for tubal patency testing. However, several HyCoSy contrast media are no longer available and saline/air mixture only allows for a brief ultrasound visualisation. Consequently, in 2010, hysterosalpingo-foam sonography (HyFoSy) emerged as a promising alternative to supersede HyCoSy. The HyFoSy technique utilizes a non-embryotoxic gel containing hydroethyl cellulose and glycerol (ExEm®-gel) mixed with purified water (purified ExEm®-water) (IQ Medical Ventures BV, Rotterdam, The Netherlands). The ExEm®-Foam is suitable to pass the fallopian tubes with the sufficient stability to allow ultrasound visualisation for at least five minutes. |
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