Test / Diagnostic Procedure: Hysterosalpingo Contrast Sonography (HyCoSy)

HyCoSy is an investigation of the fallopian tubes, usually carried out if you are having difficulty getting pregnant.

To book offline, call our Womens Health centre directly on: 020 3653 2008

Enquiries: bookings.womenshealth@onewelbeck.com

What is HyCoSy?

HyCoSy is an investigation of the fallopian tubes. It is not possible to see the fallopian tubes with normal x-rays or ultrasound. This test involves the use of a dye (contrast agent) specially designed for use with this type of test. The dye is safe and will not affect future fertility or have any effect on the fallopian tubes; it is used so that we can see the fallopian tubes much better on the ultrasound scan.

The HyCoSy test is performed by a sonographer with specialist skills in carrying out this type of procedure.

You will have been sent for this test if you are having difficulty getting pregnant. The fallopian tubes carry the egg from the ovaries to the uterus. If the tubes are damaged or blocked it may be difficult to become pregnant. Your doctor will need this information about your fallopian tubes to understand whether the tubes may be blocked or damaged. This test result can help the doctor to plan any future care you may need.

What to expect at your appointment

The scan will take approximately half an hour. Prior to the scan commencing you will be asked to empty your bladder and will then be shown into the examination room. You will be made comfortable on the examination couch and a transvaginal (internal) ultrasound will be carried out.

A speculum is then placed into the vagina (like a cervical smear examination) and a catheter (tube) is inserted into the uterus. Dye is then injected down the catheter and if the fallopian tubes are open, the dye will be seen within the tubes on the ultrasound scan. Not seeing dye in the tubes does not always mean the tubes are blocked but this information is useful for your consultant to help in planning your care and future treatment.

Whilst this scan is unlikely to be painful, some ladies may experience ‘period type’ pains during and shortly after the scan. You are therefore advised to take an anti-inflammatory pain relief such as Ibuprofen or Neurofen half an hour before the examination. If you are unable to take an anti-inflammatory pain relief, Paracetamol may be taken instead.

Frequently Asked Questions

Can HyCoSy improve fertility?

HyCoSy is an investigation to look at tubal patency (to check if the tubes are open) and there are some studies that suggest after HyCoSy the chances of natural conception/pregnancy is slightly higher.

What is the difference between a Hysterosalpingogram (HSG) and a HyCoSy test?

The procedure is exactly the same, but HyCoSy looks at the tubes and the womb with ultrasound, whilst HSG uses low dose X-ray. Depending on what your doctor is looking for, one test may be more suitable than the other.

What happens during a HyCoSy procedure?

You will be asked to change into a hospital gown. A sample pot will be given to you for a urine sample as we may do a pregnancy test (please come with a full bladder).

Your consultant will take a brief history from you and consent you for the procedure.

An internal (transvaginal) ultrasound will be performed first to ensure normal findings in the uterus (womb), ovaries and no signs of pelvic collections or infections.

You will be asked to lie on the examination table and the consultant will insert an instrument called a speculum into the vagina to hold the walls apart so that the cervix can be seen (the same procedure as having a smear test performed). A small thin, soft tube will be inserted into the cervix and liquid (saline or foam) will then be injected slowly into your uterus.

The speculum is then removed, and the transvaginal probe is again inserted. The flow of the contrast is monitored with the ultrasound until the liquid is seen passing along the fallopian tubes and eventually (if there are no blockages) spilling out at the ends into the pelvis. You may experience some discomfort with mild ‘period-like’ cramps as the fluid is injected. This should not be severe and generally settles quickly. Overall, the procedure takes about 25-35 minutes.

For more information about the procedure at OneWelbeck, please read our HyCoSy patient booklet.

What does the HyCoSy procedure at OneWelbeck include?

The procedure includes a consultation with a consultant, and a detailed transvaginal ultrasound scan and Antral follicle count which is all inclusive in the price package.

Unlike other centre's, the HyCoSy procedure at OneWelbeck uses saline followed by foam to assess the cavity and check tubal patency which is all included in the price. This is then followed by a detailed explanation of the results.

This procedure can be self-referred and can be booked directly via the website.

When do I receive the results?

Provisional findings are provided by your consultant directly after the procedure within the same consultation.

What determines the success of HyCoSy? – What if my test is abnormal?

Upon completion of the HyCoSy, your results will be given to you. If the results are abnormal – e.g., if the tubes are blocked, the doctor will explain the next steps which may include another procedure to open the tube, or further gynaecological assessment such as an MRI. Not all abnormal results require further intervention, but this will be explained to you at your consultation.

Is HyCoSy painful?

Most people find HyCoSy uncomfortable but not painful. During the procedure, the consultant will check how much discomfort you are in and adjust their technique accordingly. Most people experience “period-like” cramps when the fluid is injected.

What are the potential side effects or risks of HyCoSy?

With the HyCoSy there is a 1% risk of infection – this risk is reduced with a single dose of antibiotics given to you immediately after the procedure. And in some cases, the procedure may not be completed for example, your cervix may not be visible or the fluid leaks out. In such cases, we will rearrange the procedure for you, free of charge.

Can I have sexual intercourse after HyCoSy treatment?

Yes! We encourage this. As HyCoSy is a form of flushing of the tubes, there is a theory that natural conception may be higher after this procedure. Therefore, we encourage the patient to attend conception. You can have intercourse from that evening. Please note that there is no guarantee that HyCoSy will result in conception.

When is the best time to book a HyCoSy procedure?

It is best to book the test at least 24 hours after menstrual bleeding stops and before ovulation.

The HyCoSy can be done anytime from when you stop bleeding, up to day 18, however we recommend the test to be done prior to your ovulation cycle which is usually between days 5 to 14 (this can vary from person to person). If you are having a HyCoSy after an operation, you must have a normal period before you can have the procedure.

We now offer HyCoSy with Lipiodol

OneWelbeck is proud to be the first facility in the UK to offer HyCoSy (Hysterosalpingo-Contrast Sonography) with LipiodolÒ. This innovative approach combines the traditional HyCoSy procedure with Lipiodol, a poppy-seed oil-based contrast medium, to provide further benefit to you during your procedure.



Health Insurance

This service or treatment is generally covered by most health insurance policies. You are responsible for checking your insurance policy cover, and you may need a referral letter. Check which insurance companies are covered.


Self-Pay Available

This treatment is available for self-paying users. If you would like to see more information on pricing visit our pricing and payments page.


Consultation Required

For this treatment you will need to have a 1-to-1 consultation at OneWelbeck first. To book in with our team of expert clinicians or to find out more about the process contact the relevant centre team.


Next Day Availability

We usually have next day availability for this service, please call us to check availability.


Self Referral

No doctor referral needed in order to book this service, although health insurers may require a referral in order for your treatment to be covered.