Is a HyCosy/HyFosy necessary (to check patency of tubes) to decide if another IVF cycle (PCSI) is worth doing? And- PCSI or IUI?

[Angel17]

The NHS nurse I spoke to following my first and only IVF (ICSI) cycle said that there is no conclusive evidence that patency of tubes affects success of ICSI, the checking of tubes is only done if having an IUI (which is why the NHS Consultant didn't check them). Going elsewhere- With the knowledge that the sperm analysis done for the NHS IVF cycle showed poor motility and morphology, the private consultant I saw said that he would recommend getting my tubes checked mainly due to our unexplained infertility by natural conception - by HSG through my GP - and secondly that there was some evidence to say fluid in the tubes does affect the implantation in IVF (ICSI). He doesn't recommend HyFosy because of the inaccuracy in reading that kind of scan ie. the contrast isn't good enough (I assume compared to iodine on x ray). Therefore he doesn't usually offer it, therefore he doesn't have much experience doing it. So Im confused - a HyFosy would be my preferred choice rather than HSG due to avoiding radiation, but 1. is it efficient enough to conclude patency of tubes? and 2. Is it necessary in order to know whether to proceed with another ICSI procedure (actually we intended on doing PCSI to be exact). The other thing is another sperm analysis done at the private clinic showed no abnormality this time and so should we do IUI now (and hence HysFosy could be useful according to NHS) or PCSI still for the best chance for success? (a private clinic abroad says IUI is a lot less successful, a clinic here says on its website IUI is its most successful IVF treatment)

[DianeArnold Partner Nurse Fertility Network UK]

Hi Angel17. A HyCosy or HSG tubal patency test is often recommended before IVF or similar treatments, to check whether there is any blockage that prevents excess lubrication in the tubes from escaping into the pelvic area. If it escapes into the womb, many specialists now believe that the fluid could prevent a developing embryo from implanting, so that is why it is requested, especially if a cycle has been unsuccessful. The PICSI process is much more expensive than straightforward ICSI, but it does enable the embryologist to select a perfect sperm to use. Hope all goes well with whatever you decide. Diane

[Angel17 in reply to DianeArnold]

Thanks but my questions were - is HyFosy efficient enough to detect fluid in the tubes (compared to having an HSG), is having the HyFosy necessary to know whether to proceed with ICSI and thirdly is IUI a better option success-rate wise than ICSI or PCSI when we know sperm analysis is normal?

[DianeArnold Partner Nurse Fertility Network UK in reply to Angel17]

Hi Angel17. Yes, a HyCoSy is sufficient to pick up any anomalies in the Fallopian tubes, and is usually requested before going ahead with most forms of fertility treatment, especially IVF/ICSI cycles. Having IUI is best discussed with your specialist, as it can take many cycles before it works, whereas with ICSI, hopefully you would create extra embryos to store frozen for future use. Good luck with whatever is decided. Diane

[Angel17 in reply to DianeArnold]

Thank you very much both of you x

[KittyK]

My specialist at the NHS made me have a hycosy before he would refer me to the private IVF fertility clinic. It was useful I thought to rule out any issues and ensure we weren't spending all that money/going through all that without knowing the full story. It was quite painful but the actual probing bit only lasts a few minutes and was well worth it. I'd recommend personally. Xxx