Dr. Michael Grynberg, Director of Reproductive Medicine & Fertility at Hôpital Antoine Béclère, talks about how ultrasound can provide critical information for women struggling to get pregnant—and why it’s easier on patients.

Q: What are the standard modalities for evaluating tubal patency?
A: Laparoscopy and Hysterosalpingogram (HSG) are the most common ways to look for a blockage, but are invasive, uncomfortable and can require many appointments. The main advantage of HSG is that you can avoid laparoscopy, but x-ray and contrast are involved, so patients are exposed to radiation and the exam can be quite painful. The tests aren’t always necessary because there are ultrasound options that can also provide answers.

Q: How do you test tubal patency in your practice and why?
A: For the basic workup, I recommend 3D hysterosalpingo contrast sonography (HyCoSy) or hysterosalpingo foam sonography (HyFoSy). I think you get the same information as HSG in the end, but you don’t have the drawbacks, such as exposure to radiation or possible pain. Using Voluson’s™ 3D technology, these tests are extremely simple and non-invasive. The exam can also be coupled with Sonohysterography—and this allows you to get a better look at the uterine cavity and other possible causes of infertility, like myomas, polyps or malformation. Besides making the right diagnosis, I think it’s very important to think about the patient experience—and that includes providing an overall fertility workup in one day.

Q: What happens during your ultrasound assessment?
A: I take a two-step approach for the exam—beginning with a sonohysterography. A small amount of saline fluid is administered into the uterine cavity with a catheter. Using the Voluson probe in 3D mode, we can increase the sensitivity for the diagnosis of any uterine abnormalities. A few minutes later, we administer a foam gel through the same catheter to assess the tubes, which is called HyFoSy. While 2D is enough to evaluate tubal patency, Voluson’s 3D ultrasound allows for a more comprehensive exam and is the only way to see all portions of the tube. If the tubes are patent, the contrast will be visible around the ovaries, indicating everything is normal.

Q: Lack of skill of confidence could be a factor in a physician’s decision to utilize ultrasound for the fertility workup. How would you describe the learning curve for Voluson technology in HyCoSy and Sonohysterography exams?
A: It is not hard to master the procedures, especially for physicians who have performed basic ultrasounds. I’d tell my colleagues that you can get all this reliable information from Voluson ultrasound so it’s an overall gain. Learning the technology should not be considered a drawback.

Q: How has Voluson ultrasound technology made an impact on Reproductive Medicine?
A: Voluson is probably the best we have yet. GE works a lot in the field of gynecology and builds tools that are adjusted to our needs. They appear as a revolution for us with the 3D, all the technology, and software. They have totally changed the role of ultrasound in reproductive medicine and are part of all the good outcomes we are able to have with our infertility treatments.

Dr. Michael Grynberg is Director of Reproductive Medicine & Fertility at Hôpital Antoine Béclère, near Paris, France. He’s a fertility specialist with expertise in Oncofertility, which aims to expand reproductive options for women with a cancer diagnosis. Learn more about Dr. Grynberg’s clinic