EP25.23: Prevalence of contrast venous intravasation during hysterosalpingo‐contrast‐sonography: asystematic review and meta‐analysis

To assess the prevalence of contrast-venous intravasation during hysterosalpingo-contrast-sonography (HyCoSy) for assessment of tubal patency in infertile women. Systematic review of literature using database search (Pubmed, Scopus and Web of Science) of articles published between January 2000 and March 2024 evaluating the presence of contrast-venous intravasation during HyCoSy for assessment of tubal patency in infertile women. We used the following terms: “intravasation”, “uterine”, “tubal patency”, “ultrasound”, “ultrasonography”. The pooled prevalence for intravasation phenomenon was estimated. Heterogeneity was assessed by calculating I2. Quality of studies was assessed using the Newcastle-Ottawa scale. The search identified 74 studies. After exclusions, 10 articles that met inclusion criteria were included, comprising data from 4612 women. Eight studies (all from China) used SonoVueTM as contrast agent and two studies (both from Australia) used ExEmFoam as contrast agent. Pooled prevalence for contrast intravasation was significantly higher for SonoVueTM (21.0%, 95%CI: 20.0%-22.0%) than for ExEmFoam (7.0%, 95%CI: 5.0%-7.0%). However, the sample size was significantly lower in ExEmFoam studies (N = 488 versus N= 4124). No heterogeneity was observed between studies (I2: 0%). Studies quality was good Contrast-venous intravasation is a common phenomenon during HyCoSy procedures using SonoVueTM as contrast agent. It seems to be much less frequent when using HyFoSy.