Clinical Image & Video Gallery
When constituted, ExEm® Foam produces approximately 127,000 micro air bubbles per ml, making the image bright and white, providing a clear view of where the foam is. When the foam is injected into the uterus and tubes, patent fallopian tubes will appear as a thin, echogenic (bright white) line, when visualized with ultrasound. If the white line does not appear, the tubes might be occluded. ExEm® Foam is the only FDA-approved contrast agent for use with Trans Vaginal Ultrasound (TVUS), which can be performed as an in-office procedure.
Distal view of large Hydrosalpinx
Hydrosalpinx proximal to distal
3D reconstruction with bilateral spill
ExEm® Foam images of the uterus with the fallopian tubes in two women with known or suspected infertility. The left column shows patency in both fallopian tubes and the right column shows occlusion in left tube.
Technology used (top to bottom):
• 2D-HyFoSy (A+B)
• Offline HD-live rendered
• 3D-HyFoSy (C+D)
• 2D-HDF-HyFoSy (E+F)
• Offline color-rendered
(Source: Ludwin I, et al. 2017)
Images (E) through (F): if the foam flow is present throughout the catheter, the uterus, and the patent tube during infusion, positive contrasting by the foam is significantly enhanced by color (left column). One fallopian tube is occluded in the right column: in (B) and (D), it is partially contrasted by foam, and in (F).
(Source: Ludwin I, et al. 2017)
Patient Case Studies
“That is just shining so brightly!”, is commented in this video during a HyFoSy tubal patency procedure using ExEm Foam. The diagnosis was made confidently, quickly and easily. As demonstrated in the video, the continuous forward flow of the foam moves all the way to the end of the tube and spills out the fimbriae into the adnexa. The normal dilatation of the tube in the infundibulum portion is well demonstrated in the video.
Video credit: The Fertility Center (Grand Rapids, Michigan)
Patient case: Infertility patient was in need of a tubal evaluation. She was nervous due to history of vasovagal syncope and not tolerating exams very well, as well as fear of fainting. After the HyFoSy exam, patient expressed she had no pain and only minimal cramping.
Diagnosis: Both of the patient’s tubes were patent.
Equipment used: GE Voluson Swift, balloon catheter
Dr. Bryann Bromley of Diagnostic Ultrasound Associates states that this video example, “… shows the power of ExEm® Foam. This patient had a BMI of 52 … we struggled with the 3D reconstruction of the uterus and yet, the tubal patency was completely evaluable with foam.” Because of Dr. Bromley’s confidence in ExEm® Foam, she used HyFoSy as her first diagnosis option as she sees the value and clarity when dealing with difficult cases.
Video credit: Dr. Bryann Bromley, Diagnostic Ultrasound Associates
Patient case: Infertility patient was in need of a tubal evaluation. She had a BMI of 52.
Diagnosis: Both of the patient’s tubes were patent.
Equipment used: GE HealthCare Voluson Ultrasound E10, Balloon catheter
