Response to Letter to the Editor From Marin et al: “The SELFI Study: Iodine Excess and Thyroid Dysfunction in Women Undergoing Oil-Soluble Contrast Hysterosalpingography”

We thank Marin et al. for their letter. While hysterosalpingo-foam sonography (HyFoSy) is a reliable way of assessing tubal patency, the recommendation by the authors that this should be viewed as the preferred procedure is premature.

The only randomized studies confirming improved pregnancy outcome following tubal flushing procedures remain those using hysterosalpingograms performed with oil-soluble contrast media (OSCM). There has been no randomized study comparing HyFoSy with any other tubal flushing technique to examine pregnancy outcome as was clearly stated in the FOAM study, and the studies cited by the authors do not confirm improved pregnancy rates from HyFoSy alone...