What is HyCoSy/ Aqua scan?

HyCoSy (Hysterosalpingo-contrast-sonography) is a straightforward procedure, which is used to assess the patency of the fallopian tubes using advanced 3D ultrasound to test for common symptoms such as blocked fallopian tubes. 

The fallopian tubes are the place where female egg meets with the sperm to create a baby. If there is a blockage, it might stop you becoming pregnant. Fallopian tubes can become blocked i.e. following a pelvic infection, or after surgery.  

Aqua scan (saline hysterosonography) is an ultrasound examination of the uterine cavity to exclude any pathologies such as fibroids, polyps or a uterine septum. 

HyCoSy can show if your fallopian tubes are open or closed with the use of ultrasound. It is a very attractive alternative to older tests such as hysterosalpingogram (HSG), which is an X-ray test involving injecting a dye through the cervix. HyCoSy is simple, well-tolerated and does not use X-rays or any kind of radiation.  

The fallopian tubes can also be assessed by a simple operation called laparoscopy. However this is a surgical procedure done under general anaesthetic, therefore is more invasive and carries more risks. 

During the test we can also examine the cavity of your uterus, to check that there are no problems such as polyps or fibroids that might affect a pregnancy.  

It is particularly recommended for women wishing to undergo intra-uterine insemination (IUI) and need to know whether their tubes are open. 

  • You may experience some discomfort during the procedure like a mild period pain.  
  • Occasionally you may bleed slightly once the test has finished. The bleeding will not be heavy and should settle down within 24 to 48 hours.  
  • Very rarely infection may develop after the procedure and could become apparent days later. If you develop any symptoms such as fever, foul smelling discharge or pain, you need to contact us as soon as possible.  
  • In about 5% of cases, the results of the test are not conclusive. In this case, you may need further tests to assess the patency of your tubes.

On the first or second day of your period, contact us to book your test. The test will usually be done 1 to 2 weeks after your period starts. Note that the test cannot be done when you are on your period. 

Please use protection (condoms) if
you have sex from the first day of your period until the test. This is to prevent any chance of you being pregnant while having the test.  

Please inform us if you have any known allergies to contrasts, shellfish, iodine or antibiotics. 

It is recommended to take 400mg of Ibuprofen and/or 1g of Paracetamol one hour before the test, in order to reduce the amount of discomfort you may experience. You will also be prescribed antibiotics to take for 3 days, starting the day before the test.  

You are also advised to bring a sanitary towel with you, since you may experience slight vaginal bleeding after the test.  

You may eat and drink normally before and after your procedure.  

The procedure lasts for approximately 15 to 20 minutes and does not normally require anaesthesia. However if you find vaginal examinations too painful can be done under sedation. 

You will be asked to empty your bladder and lie down on the examination couch. Your legs will be supported in stirrups and we will ensure you are comfortable at all times. A speculum will be gently inserted into your vagina to allow us visualise your cervix. This part of the test is very similar to a smear test. 

Under ultrasound guidance a thin catheter will slowly be passed through your cervix and a small amount of normal saline will be injected through to show up the lining and 
cavity of your uterus. This will allow us to observe for the presence of any abnormalities such as uterine polyps or fibroids.  

Following this, a special ultrasound fluid will be injected through the catheter into the uterus, to show up your fallopian tubes and examine whether they are open or blocked. This fluid will easily be absorbed in the body. 

You should be able to return to work on the same day. You can carry out normal daily activities and you can resume having unprotected sex if you wish. The fluid used may cause some spotting, so you may need a sanitary towel. Do not use tampons, as may increase the risk of infection.