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Multicenter Study
. 2022 Feb 13;22(1):41.
doi: 10.1186/s12905-022-01606-3.

Is hysterosalpingo-foam sonography (HyFoSy) more tolerable in terms of pain and anxiety than hysterosalpingography (HSG)? A prospective real-world setting multicentre study

Lucía Serrano González  1   2 , Tirso Pérez-Medina  3 , Beatriz Bueno Olalla  4 , Ana Royuela  5 , María de Los Reyes De La Cuesta  3 , David Saéz de la Mata  4 , Esther Domínguez-Franjo  6 , Laura Calles-Sastre  3 , Virginia Engels  3
Affiliations
Multicenter Study

Is hysterosalpingo-foam sonography (HyFoSy) more tolerable in terms of pain and anxiety than hysterosalpingography (HSG)? A prospective real-world setting multicentre study

Lucía Serrano González et al. BMC Womens Health. .

Abstract

Background: In 60% of sterile couples a female factor is present, with these being tubal factors in 30-50% of cases. A tubal patency test is also required in women without a male partner undergoing fertility treatment. Thus, an accurate, safe and tolerable technique should be available. The aim of this study is to determine and to compare hysterosalpingo-foam sonography (HyFoSy) and hysterosalpingography (HSG) tolerability in terms of pain and anxiety.

Methods: This is a prospective real-world setting multicentre study conducted in two tertiary hospitals in Madrid. 210 infertile women/women without a male partner looking to get pregnant were recruited; 111 for the HyFoSy group and 99 for the HSG group. Tolerability was measured in terms of anxiety by the State Trait Anxiety Inventory (STAI) and pain by the Visual Analogue Scale (VAS).

Results: Median VAS score in HyFoSy group was 2 (P25; P75: 1; 3) versus 5 (4; 8) in HSG group, p < 0.001. The median State-STAI score in the HSG group was 18 points (10; 26) versus 10 (7; 16) in the HyFoSy group (p < 0.001); the median Trait-STAI score in the HSG group was 15 (11; 21) versus 13 (9; 17) in the HyFoSy group (p = 0.044).

Conclusions: HyFoSy shows higher tolerability to both: pain and anxiety. It is related to less pain and less post-test anxiety than HSG.

Keywords: Anxiety; Hysterosalpingo-foam sonography (HyFoSy); Hysterosalpingography (HSG); Pain; Tolerability.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flowchart of study participants. Patients recruited losses to follow-up and test failures
Fig. 2
Fig. 2
Trait-anxiety and state-anxiety. Trait-STAI questionnaire (how one generally feels) was filled out at the recruitment visit, while the State-STAI questionnaire (how one feels at the moment) was filled out just after the test. We can see how in the HSG group, anxiety increases following the procedure, while in the HyFoSy group it decreases. The median Trait-STAI score in the HSG group was 15 (11; 21) versus 13 (9; 17) in the HyFoSy group (p = 0.044); the median State-STAI score in the HSG group was 18 points (10; 26) versus 10 (7; 16) in the HyFoSy group (p < 0.001)
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