Fertility Imaging

These are medical examinations using ultrasound or X-ray imaging to understand infertility or to perform a fertility assessment.

Endovaginal Ultrasound
Pelvic ultrasound is the first exam performed to assess female reproductive organs. It is performed using a probe inserted vaginally. The number of small follicles, called “antral follicles,” in each ovary is counted. This number provides an idea of your ovarian reserve, i.e., your potential response in case of ovarian stimulation.

Several pathologies associated with infertility are also checked:

• Uterus: presence of fibroids, polyps, or congenital anomalies such as a septum.
• Ovaries: detection of cysts, particularly related to endometriosis.
• Fallopian tubes: assessment for hydrosalpinx, commonly called “dilated tube.”

This ultrasound is usually performed in the first days of the menstrual cycle.

SIS (Saline Infusion Sonography or Hysterosonography)
This exam allows visualization of your uterine cavity (endometrium) and uterine walls (myometrium). It is ideally performed at the end of your period, before the 11th day of your cycle. You are positioned gynecologically, and after vaginal disinfection, a soft catheter is placed in the uterus to instill saline solution to detect possible intrauterine pathologies causing infertility. The sonographer explains each step during the exam.

HyFoSy (Hysterosalpingo-foam-sonography)
This exam is performed in gynecological position after vaginal disinfection to evaluate the patency of the fallopian tubes and detect any pathologies that could explain infertility. It is performed at the end of your period, before the 11th day of your cycle. It requires the injection of a specific foam gel (ExEm® Foam) using a soft balloon catheter placed inside your uterus.

It is recommended to take a painkiller one hour before the exam, as it can be painful like heavy periods for some patients.

Your prescribing physician will evaluate whether antibiotics are necessary before the exam. A PCR test for chlamydia or gonorrhea in the cervix or urine is useful for prevention. If a tubal pathology is discovered, the sonographer will reassess the need for antibiotics if it has not been done previously. The sonographer explains each step during the exam.

Complete Fertility Assessment
This exam first involves a complete endovaginal ultrasound, followed by a SIS. The catheter used for this exam remains in place and is used for the injection of ExEm® Foam. This allows visualization of both the inside of the uterus and the patency of the fallopian tubes in a single appointment. Ideally, it is performed before the 11th day of your cycle. Prophylactic antibiotics may be prescribed if necessary. It is also recommended to take a painkiller one hour before the exam.

Assessment of Vascularization / Endometrial Receptivity
This exam is proposed in cases of repeated embryo implantation failures.

The sonographer examines the vascularization of your uterine arteries and the volume of your endometrium. This exam is ideally performed the week after ovulation or following a specific hormonal treatment prescribed by your gynecologist.

If the results are abnormal, the sonographer may propose a treatment of at least three months before reassessing endometrial receptivity.

During the second exam, a biopsy of your endometrium may be performed for histopathological analysis to detect acute endometritis. You can discuss with your doctor the relevance of this analysis in your specific case.

Hysterosalpingography
This exam tests tubal patency and the shape of the uterine cavity. It takes place in the radiology department since it uses X-rays and contrast medium instilled into the uterus by a gynecologist. The radiologist interprets the images.

It is performed at the same time of the cycle and with the same precautions as HyFoSy.

It is now rarely prescribed since HyCoSy was developed.

Take a painkiller, such as an anti-inflammatory (e.g., Ibuprofen 400) or a spasmolytic like Buscopan, about 1 hour before the exam, as uterine contractions may occur during the procedures.

Do not forget your written request signed by your prescribing physician.

Our fertility imaging team consists of gynecologists who are also part of the IVF team. You benefit from their dual expertise for detecting abnormalities and understanding your infertility.

Appointment procedures for gynecological ultrasound (route 178):

• For evaluation ultrasounds, SIS, or HyFoSy: call 02/555.36.36 as soon as your period starts to schedule an appointment before the 11th day.
• For hysterosalpingography: call 02/555 33 12 as soon as your period starts to schedule an appointment before ovulation.

Gynecology-Obstetrics Service

• Dr. Margherita CONDORELLI
• Dr. Noé MOUTARD
• Dr. David PENING
• Dr. Mélodie VANDER BORGHT

Associated Services

Radiology Service

• Pr SADEGHI MEIBODI NILOUFAR