What is a tubal patency test?
The fallopian tubes connect the ovaries to the uterus and play a crucial role in natural fertilization. If they are stuck together or blocked, the egg cell and sperm cannot meet. For clarification, we use hysterosalpingo-foam sonography (HyFoSy) at our fertility center – a particularly gentle, radiation-free method. A special contrast foam is introduced into the uterus via a thin catheter. On ultrasound, we can directly observe whether the foam flows through one or both fallopian tubes and whether the tubes are therefore patent.
HyFoSy is performed without X‑ray radiation, takes only about 5–10 minutes, and is generally well tolerated. We can discuss the results with you immediately afterwards.
When is a HyFoSy / HyCoSy useful?
A HyFoSy / HyCoSy is recommended in particular in the following situations:
- in cases of unfulfilled desire for children
- if tubal adhesions or blockage are suspected
- in cases of diagnosed or suspected endometriosis
- after a previous ectopic pregnancy
- in cases of recurrent inflammation in the abdominal or pelvic area
- prior to a planned IUI, IVF, or other fertility treatment
When is a HyFoSy / HyCoSy useful?
HyFoSy is useful as part of fertility diagnostics when it is necessary to clarify whether one or both fallopian tubes are patent. This is particularly important if pregnancy does not occur despite regular unprotected intercourse, or if there are indications of possible changes to the fallopian tubes.
In cases of endometriosis, previous inflammation, or surgery
Endometriosis, inflammation in the pelvis, or previous surgery can affect the fallopian tubes and cause adhesions. HyFoSy can be used to examine whether the fallopian tubes are patent. However, adhesions in the abdominal cavity outside the fallopian tubes cannot be reliably assessed with this examination.
After an ectopic pregnancy
After a previous ectopic pregnancy, it may be useful to check the patency of the remaining tube or of both fallopian tubes. HyFoSy can show whether flow through the fallopian tubes is possible.
Before insemination or other fertility treatments
Before insemination (IUI) or hormonal stimulation, it is advisable to check tubal patency. Because fertilization takes place in the body with these treatments, at least one patent fallopian tube is an important prerequisite for pregnancy.
The importance of tubal patency when trying to conceive
Gold standard
Open fallopian tubes are an important prerequisite for a natural pregnancy: after ovulation, the egg is picked up by the fallopian tube, where it can meet sperm and be fertilized. The early embryo then travels through the fallopian tube into the uterus. If a fallopian tube is blocked or its function is impaired, this natural process can be more difficult.
An additional effect of the examination is so-called tubal flushing: introducing the contrast foam simultaneously flushes the fallopian tubes. This can loosen small deposits or adhesions. There is evidence that tubal flushing may increase the chance of spontaneous pregnancy in the following months.
Additional examinations and treatments
Hormone testing can additionally show whether follicle maturation and ovulation are proceeding normally and whether hormonal factors are affecting fertility.
To optimally interpret the examination and plan further steps, cycle monitoring can be useful—especially if ovulation is difficult to predict.
If desired, HyFoSy can be combined with hydrosonography of the uterine cavity or performed as the next step. Sterile saline solution is introduced into the uterus so that the uterine cavity can be assessed particularly well on ultrasound. This can identify, for example, polyps, fibroids, or adhesions that may impair implantation.
The tubal findings are incorporated into treatment planning together with the other examination results. Depending on your individual situation, options may include hormonal stimulation, insemination (IUI), or IVF.
How is the tubal patency test (HyFoSy) performed?
HyFoSy is an outpatient examination and usually takes only a few minutes. Anaesthesia is not required.
-
Preparing for the examination
The examination takes place in the first half of the cycle after the end of menstruation and before ovulation, depending on cycle length usually between approximately day 6 and day 12 of the cycle. At the start, we perform an ultrasound and check whether the prerequisites for the examination are met and whether there are any indications of an existing infection.
Make an appointment -
Insertion of the catheter
For the examination, a thin, flexible catheter is gently inserted through the cervix into the uterus. Anaesthesia is not necessary. We use ultrasound to check the exact position of the catheter to make the examination as comfortable and accurate as possible.
-
Introducing the contrast foam
A special contrast foam (EXEM® FOAM) is then introduced via the catheter. It consists of a water-soluble cellulose-based gel, glycerol, and purified water, contains no iodine, and is generally well tolerated. Mixing it with air creates a fine foam that is clearly visible on ultrasound. This allows us to directly observe whether the foam flows through the fallopian tubes.
-
Assessment of tubal patency
On ultrasound, we observe how the contrast foam flows through the fallopian tubes. If the tubes are patent, it can be seen passing through the tubes and then exiting into the abdominal cavity near the ovaries. If you wish, you can follow the examination directly on the ultrasound monitor. At the same time, the contrast foam flushes the fallopian tubes and small adhesions may be loosened—the so-called tubal flushing effect.
-
Discussion of the results
The entire examination takes about 15 to 20 minutes. Afterwards, we discuss the findings with you and explain which next steps are appropriate for your fertility treatment.
What does reduced tubal patency mean?
An abnormal finding does not automatically mean that pregnancy is not possible naturally. What matters is whether only one or both fallopian tubes are affected and which other factors play a role in your desire to have children. On this basis, we will discuss the next steps and possible treatment options together.
If at least one fallopian tube is patent, pregnancy can generally still occur naturally. Cycle monitoring can also be used to observe on which side the follicle is maturing and when ovulation is expected. Depending on age, how long you have been trying to conceive, and other findings, an individual decision can be made as to whether to wait for a spontaneous pregnancy or whether fertility treatment, such as hormonal stimulation or insemination (IUI), is advisable.
If both fallopian tubes are blocked, the egg cell and sperm cannot meet naturally. In this case, IVF is often the most suitable treatment option. The fallopian tubes are bypassed: eggs are retrieved from the ovaries and fertilized outside the body. The embryo is then transferred directly into the uterus.
Fallopian tube diagnostics in Munich – our expertise and experience
Book a consultation appointment-
Gentle diagnostics
HyFoSy enables a reliable assessment of tubal patency by ultrasound—without X‑ray radiation and without anaesthesia. The examination is generally well tolerated, though it may cause brief, period-like cramping.
-
Experienced specialists
The examination is performed by specialized fertility doctors and assessed in the context of your overall fertility diagnostics.
-
Immediate results
Tubal patency can be assessed during the examination itself. We discuss the findings with you immediately afterwards.
-
Individual planning of the next steps
We review the result together with your other findings and discuss which next steps are appropriate for your personal situation.
What Our Patients Say
Costs of the HyCoSy / HyFoSy examination
The costs of the tubal patency test consist of the medical examination and the required contrast foam.
To the cost overviewUltrasound-guided tubal patency test including medical consultation and subsequent discussion of findings.
Make an appointmentThe contrast foam required for HyFoSy is billed separately.
Make an appointmentNo fixed or flat-rate prices: We bill on the basis of the official scale of fees for doctors (GOÄ). According to the GOÄ, we are not allowed to quote fixed or flat-rate prices for medical services. The prices mentioned are intended to provide orientation and are typical for the treatments mentioned.
Possible VAT liability: Medical services may be subject to VAT (currently 19%). This applies if, after diagnostics have been carried out, no medical indication or confirmed diagnosis is present and it is therefore not a medical treatment in the strict sense. This can be the case in particular with social freezing treatments, but also with the treatment of single moms and same-sex couples.
We would be happy to provide you with detailed cost information for the planned treatment in advance. This allows you to clarify cost coverage with your private health insurance (PKV) as best as possible beforehand. Statutory health insurance (GKV) does not cover costs at our center.
Tolerability and possible risks of HyCoSy/HyFoSy
HyFoSy is generally well tolerated. During or shortly after the examination, you may experience temporary, period-like cramping or mild lower abdominal cramps, and occasionally slight bleeding. Infections or other complications are rare.
Alternatives to HyFoSy
In hysterosalpingography (HSG), a contrast agent is introduced into the uterus via a catheter and fixation, and X‑ray fluoroscopy is used to assess whether the fallopian tubes are patent. The method involves an X‑ray examination and radiation exposure and is used less frequently today.
A laparoscopy—also known as keyhole surgery—is particularly useful if adhesions are suspected, for example in endometriosis, or if surgery is necessary for other reasons, such as cysts or fibroids. As part of laparoscopy, tubal patency can also be examined using a dye test.
Because laparoscopy is an operation under anaesthesia, it is generally not used as the first-line examination solely to check tubal patency.
Frequently asked questions about HyCoSy
How does HyCoSy / HyFoSy work?
In HyFoSy, a special contrast foam is introduced into the uterus via a thin catheter. Ultrasound is used to observe whether the foam flows through the fallopian tubes—an indication of their patency. The examination takes about 15 to 20 minutes and is usually perceived as only mildly uncomfortable.
When in the cycle is HyFoSy performed?
HyFoSy is performed in the first half of the cycle after the end of menstruation and before ovulation. The exact appointment is individually adapted to your cycle length and bleeding. Usually between approximately day 6 and day 12 of the cycle.
What is the difference between HyCoSy and HyFoSy?
Both procedures are used to assess tubal patency by ultrasound. HyCoSy is the umbrella term for contrast-enhanced ultrasound examination of the fallopian tubes. In HyFoSy (hysterosalpingo-foam sonography), a special contrast foam is used that is particularly easy to visualize on ultrasound. This allows the course of the foam through the fallopian tubes to be followed directly. The examination does not require X‑ray radiation or iodine-containing contrast media and is generally well tolerated. At our fertility center, we perform tubal diagnostics as HyFoSy with ExEm® Foam.
Is a tubal patency test painful?
Most women find HyFoSy well tolerable, especially when the fallopian tubes are open. During the examination, temporary pulling sensations or cramp-like discomfort in the lower abdomen may occur, similar to menstrual cramps. If needed, a suitable pain reliever can be taken before the examination.
Can it be easier to get pregnant after HyFoSy?
HyFoSy may improve the chances of spontaneous pregnancy in the following months, particularly if small adhesions in the fallopian tubes are loosened. However, the likelihood of pregnancy depends on several factors—including age, tubal patency, and possible hormonal or male causes of an unfulfilled desire to have children. Studies show that the probability of spontaneous pregnancy may be increased, especially in the first months after the examination.
Can I get pregnant in the same cycle after HyFoSy?
Yes, in principle pregnancy is possible in the same cycle. Because HyFoSy is performed before ovulation, the cycle can usually be used normally afterwards. We recommend avoiding intercourse on the day of the examination and the following day. After that, intercourse is usually possible again, and pregnancy can be attempted in the same cycle.
How much does a tubal patency test cost?
At our private center, the costs for HyCoSy / HyFoSy are approx. €295. In addition, approx. €90 is charged for the required ExEm® Foam. Medical services are billed in accordance with the German Medical Fee Schedule (GOÄ). Whether and to what extent your health insurance contributes to the costs depends on your individual insurance contract.
Can I go back to work after HyFoSy?
After HyFoSy, most people can return to their usual daily routine immediately and go back to work. Occasionally, mild pulling sensations or lower abdominal discomfort may persist for a short time. A sick note is generally not necessary.
