Background: Tubal and uterine cavity diseases commonly compromise female fertility. At the present time,\r\nhysteroscopy, laparoscopy with chromopertubation and RX-Hysterosalpingography (RX-HSG) are widely accepted\r\nscreening procedures enabling the effective assessment of both tubal patency and uterine cavity. Nevertheless,\r\nconsistent evidence supports the reliability of Hysterosalpingocontrast sonography (HyCoSy) in uterine cavity and\r\ntubal patency investigation, as a part of the standard infertility work-up. This prospective study was aimed at\r\nevaluating the tolerability of the technique as well as the incidence of related side effects and complications in a\r\nlarge series of infertile patients.\r\nMethods: Pain perception of 632 infertile women was measured by means of an 11-point numeric rating scale.\r\nSide effects and late complications were also recorded.\r\nResults: The mean numeric rating scale was 2.15 Ã?± 2.0 SD. Most of the patients (374/632, 59.17%) rated HyCoSy as a\r\nnon-painful procedure, whereas 24.36% (154/632) women reported mild pelvic pain and 9.96% (63/632) classified\r\nthe discomfort as ââ?¬Å?moderateââ?¬Â. Only 6.48% (41/632) of the patient population experienced severe pelvic pain. Fifteen\r\n(2.37%) patients required drug administration for pain relief. Twenty-six patients (4.11%) showed mild vaso-vagal\r\nreactions that resolved without atropine administration. No severe vaso-vagal reactions or late complications were\r\nobserved.\r\nConclusions: HyCoSy is a well-tolerated examination and the associated vagal effects are unusual and generally\r\nmild. Consequently, we support its introduction as a first-line procedure for tubal patency and uterine cavity\r\ninvestigation in infertile women.
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