The Role of Hysterosalpingo‐Foam Sonography in the Diagnosis of Hydrosalpinx: A Prospective Clinical Study

ABSTRACT Introduction Hydrosalpinx is a major cause of tubal factor infertility. Hysterosalpingography (HSG) is the primary method for assessing tubal patency and hydrosalpinx, but its complications have prompted the use of hysterosalpingo‐foam sonography (HyFoSy). This study aimed to evaluate the diagnostic performance of HyFoSy in detecting hydrosalpinx. Materials and Methods A prospective study was conducted at the Department of Obstetrics and Gynecology, Faculty of Medicine, between June 2020 and January 2022. Twenty patients diagnosed with hydrosalpinx by HSG underwent tubal evaluation using HyFoSy. Intraluminal tubal diameter in the isthmus, ampulla, and infundibulum were measured during the procedure. Laparoscopy (L/S) served as the reference standard. Statistical analyses were performed using SPSS 20.0. Receiver operating characteristic (ROC) curves were used to determine cut‐off values, with area under the curve (AUC), sensitivity, and specificity calculated. Inter‐rater reliability was assessed with Cohen's kappa, and p values < 0.05 were considered significant. Results The mean patient age was 33.3 ± 7.9 years. No significant difference was observed in isthmus measurements between hydrosalpinx and non‐hydrosalpinx tubes ( p = 0.615), whereas significant differences were found in ampulla and infundibulum measurements ( p = 0.023, p < 0.01). For hydrosalpinx diagnosis, HyFoSy demonstrated higher sensitivity (96% vs. 88%) and specificity (80% vs. 73%) than HSG. For tubal patency, HyFoSy also showed higher sensitivity (85% vs. 71%) and specificity (96% vs. 90%). Conclusion HyFoSy provides higher diagnostic accuracy than HSG for both tubal patency and hydrosalpinx. It is a reliable and more patient‐friendly alternative for hydrosalpinx evaluation.