Factors Associated with a Post-Procedure Spontaneous Pregnancy after a Hysterosapingo-Foam-Sonography (HyFoSy): Results from a Multicenter Observational Study
Virginia Engels 1 , Margarita Medina 2 , Eugenia Antolín 3 , Cristina Ros 4 , Carmina Bermejo 5 , Nabil Manzour 6 , Irene Pelayo 7 , Ainara Amaro 2 , Pilar Martinez-Ten 5 , Cristian De-Guirior 4 , Roberto Rodríguez 3 , Laura Sotillo 3 , Isabel Brotons 6 , Reyes de la Cuesta-Benjumea 1 , Oscar Martinez 1 , Javier Sancho 7 , Juan Luis Alcázar 6
Background: Tubal patency testing constitutes an essential part of infertility work-up. Hysterosalpingo-foam-sonography (HyFoSy) is currently one of the best tests for assessing tubal patency. The objective of our study was to evaluate the post-procedure rate of spontaneous pregnancy among infertile women submitted for an HyFoSy exam with ExEm® foam and the factors associated with this.
Methods: Multicenter, prospective, observational study performed at six Spanish centers for gynecologic sonography and human reproduction. From December 2015 to June 2021, 799 infertile women underwent HyFoSy registration consecutively. The patients' information was collected from their medical records. Multivariable regression analyses were performed, controlling for age, etiology, and time of sterility. The main outcome was to measure post-procedure spontaneous pregnancy rates and the factors associated with the achievement of pregnancy.
Results: 201 (26.5%) women got spontaneous conception (SC group), whereas 557 (73.5%) women did not get pregnant (non-spontaneous conception group, NSC). The median time for reaching SC after HyFoSy was 4 months (CI 95% 3.1-4.9), 18.9% of them occurring the same month of the procedure. Couples with less than 18 months of infertility were 93% more likely to get pregnant after HyFoSy (OR 1.93, 95% CI 1.34-2.81; p < 0.001); SC were two times more frequent in women under 35 years with unexplained infertility (OR 2.22, 95% CI 1.07-4.65; P0.033).
Conclusion: After HyFoSy, one in four patients got pregnant within the next twelve months. Couples with shorter infertility time, unexplained infertility, and women under 35 years are more likely to achieve SC after HyFoSy.
CITATION Diagnostics (Basel). 2023 Jan 30;13(3):504. doi: 10.3390/diagnostics13030504