Impact of catheterization interference factors on hysterosalpingo-contrast sonography outcomes in infertility diagnosis：a cross-sectional study

Background This study aimed to summarize the various types of intrauterine catheterization interference factors encountered during transvaginal hysterosalpingo-contrast sonography (HyCoSy) and their corresponding imaging results. Methods A retrospective analysis was conducted on 3,211 patients who underwent HyCoSy, including 109 patients with catheterization interference factors. The HyCoSy results were compared between cases with smooth intubation and those with catheterization interference. The different types of intrauterine catheterization interference factors were categorized, and the results were analyzed in relation to pregnancy and delivery history. Results A total of 206 fallopian tubes were included in the catheterization interference group. The incidence of fallopian tube obstruction was significantly higher in this group compared to the smooth intubation group (33.0% vs. 20.3%, P < 0.001). There was no significant difference in the types of catheterization interference factors between primary and secondary infertility (P = 0.692), but the difference in tubal patency was statistically significant (P = 0.015). Intraoperative tubal obstruction was more frequent in patients with primary infertility and catheter dislodgement (P = 0.002). Conclusion Intubation failure was more common in patients with mediastinal uterine malformations. Patients with catheterization interference had a higher rate of tubal obstruction compared to those with smooth intubation. Among primary infertile patients, the incidence of tubal obstruction was higher when the water sac prolapsed during the procedure. For patients with secondary infertility, increasing the balloon size during intubation may help prevent interference.