What is a HyCoSy (Tubal Patency) Test & When to Get it Done

Did you know that our fallopian tubes are a highway for the egg to reach the uterus?

It’s also where our eggs wait around for sperm to get fertilised, and then move on to the uterus. 

That’s because egg cells stay alive for about 24-48 hours, and this is the time period at which sperm must swim up to them, for successful fertilisation. 

And of all the factors that could affect this journey, one important one is: blockage in the fallopian tube.

If there are blockages, it’s like a “no road ahead” sign for sperm, essentially halting them there.

But that’s what tests such as HyCoSy are here to solve.

They check for tubal patency, aka whether there’s a tubal blockage or not- and find the right treatment plan if there is one.

So, in this guide, let’s do a deep dive into what this test is, how it’s done, how to prepare and when you might need one.

What is a HyCoSy Test?

HyCoSy stands for Hystero-salpingo-contrast-sonography. It's a type of ultrasound scan that uses a special contrast fluid to check if your fallopian tubes are open and if your uterus is healthy.

Here's how it works in simple terms: 

🧪 A thin catheter (think, flexible tube) is gently inserted through your cervix into your uterus

👩🏻‍🔬A harmless contrast fluid is slowly injected while the sonographer uses an ultrasound probe to track the fluid as it flows through your reproductive system. 

🪤Your doctor can see in real-time if the fluid flows freely through your fallopian tubes or if there are any blockages.

🕰️The whole process typically takes about 15-30 minutes and is performed by a specialist sonographer or fertility doctor. 

Ideally, it’s a minimally invasive procedure, and should have little to no side effects.

HyCoSy vs HSG: What's the Difference?

Both HSG and HyCoSy check if your fallopian tubes are open and your uterus is healthy, but they do it in different ways. Here’s a quick breakdown:

HSG uses X-ray imaging and a special dye, which gives very detailed pictures. These are helpful for spotting tiny blockages or changes in the shape of your uterus. In some cases, the dye used in HSG might even help clear minor blockages. But it does involve a bit of radiation and can feel more uncomfortable.

HyCoSy, on the other hand, uses ultrasound and doesn’t involve radiation. It allows doctors to see how things look and work in real time, and it’s generally gentler. It’s great for spotting common issues like fibroids, polyps, scar tissue, or blocked tubes.

Your doctor will recommend the best option based on your specific situation, your medical history and the information they need.

Why Would I Need a HyCoSy Test?

There are some common concerns for which your doctor might bring up a HyCoSy test. Here’s a look at a few of them:

Investigating your fertility

If you've been trying to conceive for 6-12 months (or longer) without success, checking your fallopian tubes is often part of the fertility workup. About 25-35% of female fertility issues are related to tubal problems.

Unexplained Infertility 

When other fertility tests come back normal but you're still having trouble conceiving, HyCoSy can help identify hidden tubal issues and decide the best step to take. 

History of Pelvic Infections 

Previous pelvic inflammatory disease (PID), sexually transmitted infections, or abdominal infections can sometimes cause scarring that blocks the fallopian tubes.

Previous Ectopic Pregnancy 

If you've had an ectopic pregnancy, your doctor might want to check that your tubes are clear and healthy before you try to conceive again.

Endometriosis Concerns 

Endometriosis can sometimes affect the fallopian tubes, and HyCoSy can help assess whether this is impacting your fertility.

Before IVF Treatment 

Some fertility clinics recommend checking tubal patency before starting IVF, especially if there's a concern about blocked tubes that could interfere with treatment success.

Recurrent Miscarriages 

If you've experienced recurrent miscarriages, your doctor may recommend a HyCoSy to check for uterine abnormalities (polyps, fibroids, adhesions) that could be affecting your ability to carry a pregnancy.

How Should I Prepare for the HyCoSy Procedure?

Getting ready for a HyCoSy test is usually quite simple, but there are a few things you’ll want to keep in mind to make the process as smooth and comfortable as possible.

It’s always a good idea to have a quick chat with your doctor ahead of time, especially if you’re on hormonal contraception or think there’s a chance you might be pregnant. 

They’ll help decide the right timing and approach for your situation.

⏰ Timing of the Test

HyCoSy is typically scheduled during the first half of your menstrual cycle, usually between days 6 and 10. 

This timing is ideal because your uterine lining is still thin, which gives clearer images, and you’re not likely to be ovulating, both of which help improve the accuracy of the test.

🔁 Before Your Appointment 

To make the experience more comfortable, you can take a mild pain reliever like ibuprofen about an hour before your appointment—just check with your doctor first. 

On the day of your test, wear loose, comfortable clothing and consider bringing a sanitary pad with you. It’s common to have a little spotting afterward.

If there's any chance you could be pregnant, it's best to take a pregnancy test beforehand, just to be safe.

What to Avoid 

For 24 hours before your HyCoSy, it’s best to avoid vaginal intercourse, tampons, douching, or any vaginal medications. 

These precautions help reduce the risk of infection. And if you have any symptoms of a pelvic infection, make sure to let your doctor know before the procedure.

Questions to Ask Your Doctor

It’s completely normal to have questions before your HyCoSy. Some helpful ones to bring up might include:

• How long will the procedure take?
• Will it be painful, and what kind of discomfort should I expect?
• When will I get the results?
• Do I need someone to accompany me or drive me home afterward?

When you’re informed of the procedure and more prepared, you’ll eventually feel more comfortable and confident going into the test.

How Does the HyCoSy Ultrasound Work?

Here’s a quick and easy understanding of the procedure so you know what’s happening and you feel at ease during your procedure:

Initial Setup (5 minutes) You'll be asked to undress from the waist down and lie on an examination table, similar to having a smear test. The sonographer will explain each step and make sure you're comfortable.

Transvaginal Ultrasound (5 minutes) First, a transvaginal ultrasound probe is gently inserted to get baseline images of your uterus and ovaries. This helps the doctor see the overall structure before introducing the contrast fluid.

Catheter Insertion (5 minutes) A speculum is inserted (just like during a smear test), and a very thin catheter is carefully guided through your cervix into your uterus. You might feel some cramping similar to period pain during this step.

Contrast Injection (10-15 minutes) The special contrast fluid is slowly injected through the catheter while the ultrasound continuously monitors its flow. You'll be able to see the fluid on the screen as it:

• Fills your uterine cavity
• Flows into your fallopian tubes
• (Hopefully!) spills out of the tube ends, confirming they're open

Real-time Assessment 

Throughout the procedure, your doctor can see exactly what's happening and will often explain what they're observing. If your tubes are clear, you'll see the contrast fluid flowing freely through them.

The whole process is performed in real-time, so your doctor gets immediate results and can often give you preliminary findings right away.

Is the fluid used in the HyCoSy scan safe?

The contrast fluid used in HyCoSy is designed to be body-safe and is naturally absorbed or expelled. The ultrasound waves are the same as those used in pregnancy scans, so there's no radiation risk.

Most people return to normal activities the same day, though you might want to take it easy for the rest of the day if you experience cramping.

When Do I Get the HyCoSy Test Results?

One of the benefits of a HyCoSy is that you often get a sense of the results right away. 

During the procedure, your doctor watches the contrast fluid move through your uterus and fallopian tubes in real time. They’ll usually talk you through what they’re seeing—whether your tubes appear open, if the contrast is flowing smoothly, or if there’s anything that might need a closer look.

After the scan, you’ll receive a formal written report within a few days to a week. This report includes a detailed summary of your uterine cavity, an assessment of both fallopian tubes, and any findings your doctor thinks are important. In some cases, you can also request images from the scan.

Once your results are ready, your doctor will schedule a follow-up appointment to go over everything in more detail. They’ll explain what the results mean for your fertility, suggest any further tests or treatment options if needed, and answer any questions you may have.

When you book an appointment via Amilis, your HyCoSy results will be added to your overall fertility assessment to help guide the next steps in your care. Get the care you need, at affordable prices, minus the waiting time.

Book a HyCoSy Test in the UK with Amilis

At Amilis, your fertility journey starts with a free initial consultation so you can speak directly with a fertility doctor, understand which tests you actually need, and feel confident before booking anything. 

If a HyCoSy is recommended, we help you access discounted HyCoSy testing at accredited clinics across the UK—without long waiting times or complicated referral steps. 

Alongside this, you can also understand your wider fertility health through affordable hormone tests and full fertility panels starting at £80, with follow-up consultations and personalised reports.

With Amilis, you’ll have our support at every step, get follow-up guidance, and access to trusted fertility clinics and specialists, so you always know what your next step should be. 

If you’re ready to get started, book a free consultation or take our personalised quiz to understand which tests may be right for you.

You’ve got this ♥️

Frequently Asked Questions

How much does a HyCoSy test cost in the UK?

A HyCoSy scan can be free on the NHS if you meet their eligibility criteria, which usually includes a GP referral, meeting local fertility-testing guidelines, and long wait times that range from 6 to 18 months. Private clinics in the UK typically charge between £300 and £800, depending on location, and whether consultations are included, and any additional scans or follow-ups. With Amilis, you get free mini-consultations with fertility doctors and access to more affordable HyCoSy pricing, making the process a little easier to navigate.

What is the NHS waiting time for a HyCoSy test?

NHS waiting times for a HyCoSy can range from 3 to 18 months, depending on your region and local eligibility rules. Most people need a GP referral and must meet age and fertility criteria. Because the wait can be long, many choose private testing for quicker results.

How painful is the HyCoSy test?

Most people find HyCoSy mildly uncomfortable, similar to period cramps or a smear test. The cramping usually happens when the catheter goes in and when the contrast fluid is released. Taking a simple painkiller before the appointment can help, and the discomfort typically settles within a few hours.

Will a HyCoSy test help you get pregnant?

HyCoSy is mainly used to check if your tubes are open and to look for any issues in the uterus. Some people do get pregnant more easily in the months after the test because the fluid can clear small blockages, but this is a bonus rather than the main goal. The main benefit is understanding what might be affecting your fertility so you can plan the right next steps.

What is a fallopian tube dye test?

A fallopian tube dye test is another term for tubal patency testing, which includes HyCoSy and HSG. During the test, a contrast fluid is passed through the cervix and into the uterus and tubes to see whether they are open. The fluid shows up on imaging and helps doctors check for blockages or structural issues.

What are the disadvantages of HyCoSy?

HyCoSy is safe for most people, but it can cause brief cramping and a small risk of infection or reaction to the contrast fluid. It also needs to be done at the right time in your cycle and cannot be performed during pregnancy or while you have a pelvic infection. In some cases it may not pick up very fine problems in the tubes.