HyCoSy is putting a contrast medium into the uterus and scanning from the outside to get a black and white image perception.
Hysteroscopy is passing a tiny camera ( about a ballpoint pen refill size) through the cervix and looking at inside of the womb in finer details to get a coloured 3-D perception.
With HyCosy, tubal patency can be tested, but with hysteroscopy, tubal openings can be visualised.
With hysteroscopy, intrauterine adhesions ( Also called as Asheman’s syndrome) are better visualised.
Even though HyCosy is an advanced ultrasound technology, no one will do it as a primary testing. In other words, all women will need screening ultrasound scan first and then depending on the findings ( ? polyp, ? submucosal fibroid) and clinical situation ( for example – previous chlamydial infection), fallopian tubal patency may need to be tested in a subfertility situation.
But, when it comes to ruling out intrauterine assessment ( for example repeated failed IVF’s) or suspected uterine polyp or submucosal fibroid,or Asherman’s syndrome, hysteroscopic assessment of uterine cavity and if pathology found and feasible removal through hysteroscopy route remains the gold standard.
Pain or discomfort experienced in both HyCoSy and Hysteroscopy remains the same. Both tests complement each other in a few situations.
Patients who were found to have a pathology during HyCoSy will eventually need hysteroscopy.