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Master Thesis

Échographie de contraste 2D/3D de type HyCoSy dans le bilan d'infertilité féminin : première expérience au CHU de Bordeaux

Abstract : Background : The female infertility workup includes many of additional tests to be carried out at different times of the menstrual cycle. Hysterosalpingography, which is one of them, has the disadvantage of often poorly tolerated by patients, radiant and allergic risk. The need to reduce the infertility evaluation emerges. HyCoSy is a recent ultrasound technique, based on the use of endo-cavitary contrast agents and the three-dimensional, not only to visualize ovaries, the uterus and the uterine cavity, but also to explore tubal patency. In the literature, the diagnostic efficacy in terms of tubal exploration has shown very good results against reference techniques. The objective of this study was to investigate the relevance and feasibility of HyCoSy in the female infertility evaluation and, secondarily, for patients who also received the gold standard, to compare the results of exploration cavitary and tubal patency. Materials and methods : A vacation to HyCoSy was set up in the service of gynecology department and imaging of women at the University Hospital of Bordeaux with a Voluson E6 ultrasound loan for 3 months. Patients were addressed during pelvic ultrasound early cycle. A collection of tolerance of HyCoSy was performed and patients were recalled at one week and one month, looking for complications. Results : 30 patients were sent to carry out the HyCoSy. 25 patients received the full review with contrast instillation or 49 tubes. 60% of patients had a risk factor tubal damage. The maximum pain experienced was 4.9 / 10 but completely disappearing at the end of the examination. The pain was slightly higher when tubal obstruction (5.2 / 10 vs. 4.7 / 10). No significant adverse effects were reported. A diagnosis was posed for 31 tubes and 27 of which could be compared to a gold standard (hysterosalpingography or laparoscopy-blue test). Concordance is good with a kappa 0.73. Haematometra, intermediate or retroverted uterus, adenomyosis or fibrosis responsible for an increase in uterine volume, were more often present as non-diagnostic tests. Conclusion : HyCoSy is a simple examination and well tolerated, easily integrated in routine infertility workup. Respect guidance is essential: examination between the 6th and 8th day of the cycle, anteverted uterus and normal volume. In these circumstances, it is an effective screening tool for patients who need to use laparoscopy-blue test and allow the economy hysterosalpingography and hysteroscopy. The concordance with the reference HyCoSy examinations looks good but our study did not make a reliable estimate of diagnostic quality due to the large number of non-diagnostic tests and the small size of patients.
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Master Thesis
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Contributor : Bu Carreire Université de Bordeaux <>
Submitted on : Tuesday, June 23, 2015 - 2:44:06 PM
Last modification on : Wednesday, August 23, 2017 - 4:33:28 PM
Long-term archiving on: : Tuesday, September 15, 2015 - 9:51:41 PM


  • HAL Id : dumas-01166926, version 1



Céline Musset. Échographie de contraste 2D/3D de type HyCoSy dans le bilan d'infertilité féminin : première expérience au CHU de Bordeaux. Médecine humaine et pathologie. 2015. ⟨dumas-01166926⟩



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