Purpose: To demonstrate the accuracy of 3D ultrasound and transvaginal color Doppler hystero-contrast-salpingography (Hy-Co-Sy) in evaluation of tubal patency.

Material and methods: We compared the findings of color Doppler Hy-Co-Sy from 152 patients with those of chromopertubation at the time of laparoscopy. In the second part of our study we obtained data on tubal patency by 3D ultrasound Hy-Co-Sy from 58 patients. Findings were correlated with those of laparoscopic chromopertubation. The contrast media used were isotonic saline and commercial echo contrast Echovist.

Results: One hundred and forty five out of 152 (95.4 %) color Doppler Hy-Co-Sy findings agreed with observations at time of chromopertubation. Bilateral tubal patency was successfully detected by color Doppler Hy-Co-Sy in 64 out of 67 patients, while unilateral patency was shown in 36 out of 38 cases. In 45 patients color Doppler Hy-Co-Sy indicated bilateral tubal occlusion. Fifty six findings (96.6 %) obtained by 3D ultrasound Hy-Co-Sy agreed with intraoperative observations at the time of laparoscopy. Bilateral tubal patency was correctly detected by 3D ultrasound Hy-Co-Sy in each of 24 patients, while unilateral tubal patency was demonstrated in 17 out of 18 cases. In 15 patients 3D ultrasound Hy-Co-Sy indicated bilateral tubal occlusion.

Conclusions: Transvaginal color Doppler Hy-Co-Sy is a safe and efficacious method for evaluation of the Fallopian tube patency without exposure to radiation and iodinated contrast media. Three dimensional ultrasound offers the possibility of simultaneous presentation of the uterine cavity and corresponding tube, shortening the procedure and the discomfort to the patient.