HyCoSy (Hysterosalpingo Contrast Sonography)

Before your test, you’ll have a short consultation with your specialist, who’ll explain what the procedure involves, how to prepare for it, and answer any questions you may have.

When you arrive for your appointment, you’ll be shown to a private changing area and asked to change into a hospital gown. You’ll also be given a small pot to provide a urine sample, as a pregnancy test may be performed before the scan. 

The test begins with a transvaginal (internal) ultrasound, which allows your consultant to check that the womb and ovaries appear normal and that there are no signs of pelvic infection or fluid collections. You’ll be asked to lie on your back with your knees bent and slightly apart. 

Following the ultrasound: 

1. Your consultant will gently insert a speculum into your vagina (just like during a cervical smear) so that the cervix can be seen clearly. 

2. A thin, soft tube called a catheter is then passed through the cervix into the uterus.

3. The speculum is removed and a small amount of sterile contrast fluid (either saline or foam) is slowly injected through the catheter.

4. This fluid moves through the womb and along the fallopian tubes, allowing your consultant to see whether they are open or blocked.

5. A transvaginal ultrasound probe is used again at this stage to monitor the flow of the contrast fluid in real time. If the tubes are open, the fluid will be seen gently spilling out into the pelvis.

You may feel mild ‘period-like’ cramping or a sensation of fullness while the fluid is being introduced, but this should not be painful and usually settles quickly. Taking an over-the-counter painkiller, such as ibuprofen or paracetamol, about half an hour before your appointment can help to minimise any discomfort.

The entire procedure takes around 25 to 35 minutes, and once it’s complete, you’ll be able to rest until you’re ready to get dressed.

HyCoSy with Lipiodol at Welbeck 

At Welbeck, we’re proud to be the first facility in the UK to offer HyCoSy with Lipiodol – an advanced ultrasound technique that enhances traditional HyCoSy testing. This approach, known as LiCoSy, replaces the usual saline or foam contrast with Lipiodol, a poppy seed oil-based solution that offers both diagnostic and potential therapeutic benefits.

Benefits of HyCoSy with Lipiodol (LiCoSy) include: 

• no radiation – unlike older Lipiodol procedures performed under X-ray, LiCoSy uses ultrasound only, completely removing radiation exposure

• potential fertility improvement – studies suggest that Lipiodol may gently flush the fallopian tubes, clearing minor blockages and improving their openness

• improved implantation – Lipiodol may also enhance the womb’s natural environment, supporting embryo implantation in both natural conception and IVF

LiCoSY can be performed if you have normal thyroid function test results and no known pelvic infection. Your consultant will talk to you about whether it’s suitable for you.

HyCoSy is considered a very safe and well-tolerated procedure. Because it doesn’t involve X-rays or radiation, it’s a safer and more comfortable alternative to older dye tests such as hysterosalpingography (HSG). The contrast fluid used is completely safe and won’t affect your fertility or cause any harm to your fallopian tubes.

Complications are rare, but as with any medical test, there are some possible side effects:

• mild pelvic cramping or discomfort during the procedure

• light spotting for up to 24 hours afterwards

• dizziness or feeling faint 

With HyCoSy, there’s a 1% risk of infection – this risk is reduced with a single dose of antibiotics given to you immediately after the procedure. 

Occasionally, the procedure can’t be completed successfully. For example, your cervix may not be visible, or the contrast fluid may leak out. If this happens, we’ll rearrange the procedure for you, free of charge.

A HyCoSy is usually scheduled between days 5 and 14 of your menstrual cycle (after your period but before ovulation). This timing ensures that the lining of your womb is thin enough for a clear view and that you’re not pregnant. Let your consultant know if you have any allergies or a history of pelvic infection. 

You should arrive with a full bladder so that a urine sample can be taken before the test. 

Some patients find it helpful to take a mild painkiller (such as paracetamol or ibuprofen) about an hour before the procedure, to reduce any discomfort.

You’ll be able to return to your normal activities straight after your HyCoSy, but you should avoid using tampons or swimming to reduce the risk of infection. 

It’s normal to experience:

• mild cramping for a few hours

• light spotting or discharge for up to 24 hours

If you experience heavy bleeding, fever, or persistent pain, please contact your consultant.

At Welbeck, HyCoSy includes a consultation with a consultant, a detailed transvaginal ultrasound scan and an antral follicle count (AFC) inclusive in the price package.

Please contact our Women’s Health centre for pricing.

At Welbeck, our gynecologists are experts in their field and are dedicated to providing world-class care to every patient.

With access to colleagues across other specialties, our consultants are also able to refer within the Welbeck ecosystem if required to ensure you receive the treatment you need as quickly as possible, all under one roof.  

All appointments, testing, treatment, and follow-up appointments take place within our state-of-the-art facilities, enabling us to deliver accurate diagnostics and advanced treatments.

To book a HyCoSy, you may be referred by either your GP or a gynaecologist, but we also accept self-referrals for this test. 

If you would like to schedule a consultation with a Welbeck gynaecologist, please get in touch to make an appointment. Your health is important to us, so we strive to offer same-day appointments whenever possible.

Our consultants are recognised by the major health insurance companies. If you have private health insurance, your treatment at Welbeck can begin once you have obtained authorisation. We also provide care to self-paying patients. Learn more about the different payment options at Welbeck.