Infertility, defined as the inability to conceive after one year of regular unprotected intercourse, presents significant emotional, familial, and societal challenges. Women experiencing infertility often face both psychological distress and disruptions to family dynamics. Given the critical role of the uterus and fallopian tubes in reproduction, conditions such as tubal obstruction, intrauterine adhesions, endometrial polyps, and congenital uterine anomalies are major contributors to female infertility. Accurate and efficient assessment of these structures is essential for effective diagnosis and treatment.
Hysterosalpingo-contrast sonography (HyCoSy) has emerged as a valuable, non-invasive diagnostic tool for evaluating uterine and tubal pathology, particularly in assessing tubal patency. This technique involves injecting contrast agents into the uterine cavity and fallopian tubes via a catheter, allowing visualization of their structure and function. With ongoing advancements in ultrasound technology, HyCoSy has evolved into a multimodal approach that integrates two-dimensional contrast-enhanced ultrasound (2D-HyCoSy), static three-dimensional contrast-enhanced ultrasound (3D-HyCoSy), real-time four-dimensional contrast-enhanced ultrasound (4D-HyCoSy), and transvaginal ultrasonography harmonic imaging (TVS-HI).
Negative hysterography, which uses saline as a contrast agent to distend the uterine cavity, further enhances diagnostic accuracy by creating a clearer acoustic window. This technique has demonstrated high consistency with hysteroscopy in detecting intrauterine abnormalities such as endometrial pathology, submucosal fibroids, and adhesions.
This study evaluates the diagnostic potential of combining multimodal HyCoSy with negative intrauterine contrast-enhanced ultrasound for comprehensive assessment of the female reproductive tract. By integrating these methods, we aim to establish an efficient, single-step approach for accurately diagnosing uterine and fallopian tube abnormalities, ultimately improving infertility management and patient outcomes.
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