Objective: To determine the frequency of uterine contrast agent intravasation during HyCoSy/HyFoSy for assessing tubal patency in infertile women. Methods: Prospective observational multicenter study performed in nine European university hospitals, comprising a series of non-consecutive women who underwent HyFoSy (ExEmTM foam) for tubal patency assessment in the context of infertility between May 2016 and December 2022. All examinations were performed using the same scanning protocol. In addition, a systematic review of literature using database search (Pubmed, Scopus and Web of Science) of articles published between January 2000 and March 2024 evaluating the presence of venous contrast intravasation during HyCoSy/HyFoSy for assessment of tubal patency in infertile women. Pooled prevalence for intravasation was estimated. Heterogeneity was assessed by calculating I2. Quality of studies was assessed using the Newcastle-Ottawa scale. Results: Prospective study: 1946 women were recruited. Intravasation was observed in 12 cases (0.6 %, 95 % CI: 0.5 %-0.9 %). The frequency of intravasation was similar in seven centers, ranging from 0 % to 0.7 %. In two centers the frequency observed was higher, 2.6 % and 3.0 %, respectively. No significant patient reaction or complication was observed in those 12 women with intravasation. In addition, the search identified 74 studies. After exclusions, 11 articles (9 using SonoVueTM and 2 using ExEmTM foam) were included, comprising data from 5028 women. Pooled prevalence for contrast intravasation was significantly higher for SonoVueTM (23.0 %, 95 % CI: 19.0 %-27.0 %) than for ExEmFoam (7.0 %, 95 %CI: 5.0 %-9.0 %). Heterogeneity was high (I2: 91.8 %). Studies quality was good. Conclusion: Uterine intravasation is less frequent using ExEmTM foam than SonoVueTM.

Introduction: Cystic fibrosis (CF) is an autosomal recessive disease associated to low survival disease into adulthood. The appearance of the cystic fibrosis transmembrane conductance regulator (CFTR) therapy has revolutionized the management and the prognosis of these patients with an improvement in the pancreatic and lung function with a much better quality of life. More women with CF are considering being mothers. Other clinical scenario is the prenatal diagnosis of fetus with CF. Three case reports have been published, suggesting that CFTR therapy during pregnancy in fetuses affected by CF might prevent prenatal meconium ileus (MI), which are the one who have a higher risk of gastrointestinal morbidity and long-term complications. Case Presentation: We present 2 cases in which the diagnosis of CF occurred during intrauterine life and treatment with CFTR therapy was administered to healthy pregnant women in order to reduce the risk MI in their fetuses. In both cases, the diagnosis suspicion was by ultrasound findings with a genetic confirmed diagnosis by amniocentesis. In the first case, the mother received the CFTR therapy during 5 weeks and MI was not developed by the newborn. In the second one, the mother received the treatment only for a week and MI could not be avoided. Conclusion: This clinical situation has special ethical considerations, since a drug is being administered through compassionate use to a woman who does not need it. The fundamental reason is the lack of authorization for the use of these drugs in newborns but in adults. We hope that these 2 clinical cases, together with those already published, will increase the knowledge and experience of using this drug in this context helping with the management of pregnant women with fetuses affected by CF in order to reduce associated complications.

Objective: To evaluate the impact of standardizing lessons and materials across different teaching units in obstetrics and gynecology on students' satisfaction, perceived exam preparation adequacy, and the necessity for content standardization. Methods: A quasi-experimental study was conducted over two semesters with fourth-year medical students. In the first semester, faculty members from four teaching units independently designed their lessons and materials. In the second semester, standardized teaching materials were implemented across all units. Student perceptions were assessed through surveys measuring content relevance, satisfaction, exam preparation adequacy, and perceived discrepancies in teaching materials. Results: A total of 180 students participated in the first semester, and 184 in the second semester. Students in the first semester, where faculty had autonomy, reported higher satisfaction and a better perception of exam preparation adequacy (80.0 vs. 72.5, p < 0.001). The percentage of students perceiving discrepancies in teaching materials decreased after standardization (63.3% vs. 57.6%, p = 0.264). However, the proportion of students considering standardization necessary declined significantly (94.4% vs. 57.1%, p < 0.001). Additionally, nine students in the second semester rated satisfaction below 5, compared to none in the first semester (p = 0.004). Conclusions: The study suggests that while standardization improves content consistency, it may reduce student satisfaction and perceived exam preparation adequacy. A rigid standardization model may not fully address students'learning needs. A hybrid approach, balancing standardization with faculty autonomy, could optimize educational outcomes in medical training.

ABSTRACT Objectives To ascertain whether abnormalities in neonatal head circumference and/or body weight are associated with levels of angiogenic/antiangiogenic factors in the maternal and cord blood of pregnancies with a congenital heart defect (CHD) and to assess whether the specific type of CHD influences this association. Methods This was a multicenter case–control study of women carrying a fetus with major CHD. Recruitment was carried out between June 2010 and July 2018 at four tertiary care hospitals in Spain. Maternal venous blood was drawn at study inclusion and at delivery. Cord blood samples were obtained at birth when possible. Placental growth factor (PlGF), soluble fms‐like tyrosine kinase‐1 (sFlt‐1) and soluble endoglin (sEng) were measured in maternal and cord blood. Biomarker concentrations in the maternal blood were expressed as multiples of the median (MoM). Results PlGF, sFlt‐1 and sEng levels were measured in the maternal blood in 237 cases with CHD and 260 healthy controls, and in the cord blood in 150 cases and 56 controls. Compared with controls, median PlGF MoM in maternal blood was significantly lower in the CHD group (0.959 vs 1.022; P < 0.0001), while median sFlt‐1/PlGF ratio MoM was significantly higher (1.032 vs 0.974; P = 0.0085) and no difference was observed in sEng MoM (0.981 vs 1.011; P = 0.4673). Levels of sFlt‐1 and sEng were significantly higher in cord blood obtained from fetuses with CHD compared to controls (mean ± standard error of the mean, 447 ± 51 vs 264 ± 20 pg/mL; P = 0.0470 and 8.30 ± 0.92 vs 5.69 ± 0.34 ng/mL; P = 0.0430, respectively). Concentrations of sFlt‐1 and the sFlt‐1/PlGF ratio in the maternal blood at study inclusion were associated negatively with birth weight and head circumference in the CHD group. The type of CHD anomaly (valvular, conotruncal or left ventricular outflow tract obstruction) did not appear to alter these findings. Conclusions Pregnancies with fetal CHD have an antiangiogenic profile in maternal and cord blood. This imbalance is adversely associated with neonatal head circumference and birth weight. © 2023 International Society of Ultrasound in Obstetrics and Gynecology.

OBJECTIVES:To evaluate the correlation between maternal serum and urinary soluble Fms-like tyrosine kinase-1 (sFlt-1) and placental growth factor (PlGF) levels and to assess their potential value in preeclampsia and fetal growth restriction. STUDY DESIGN:This case-control longitudinal prospective study was performed in 49 singleton pregnant women, divided into two clinical groups, low risk pregnancy (n = 23) and pregnancy complicated by preeclampsia (n = 26). Maternal serum and urinary sFlt-1 and PlGF levels were quantified by electrochemiluminescence. Every patient underwent an ultrasound for fetal biometry. Doppler assessment was done when estimated fetal weight was under the 10th centile. ROC curves were used to evaluate the predictive capability of serum and urinary angiogenic biomarkers and their ratios on preeclampsia. Linear regression was used to compare the values of serum and urinary sFlt-1 and PlGF and their ratios. RESULTS:Urine biomarkers were positively associated with their serum values, being the best associated urinary PlGF (R2 = 0.73), which also showed the highest predictive capability of preeclampsia of urine biomarkers (AUC 0.866). The predictive capability of urinary sFlt-1 was much lower (AUC 0.640), but increased when adjusting by serum creatinine, a more precise parameter (AUC 0.863). CONCLUSIONS:Urinary PlGF could be a lesser invasive alternative to circulating biomarkers to monitor pregnancies complicated with preeclampsia that need repeated controls of their pregnancy complication. Urinary sFlt-1 values need adjustment by serum creatinine to be reliable.

Introduction: Nonimmune hydrops fetalis (NIHF) is the most frequent etiology of hydrops fetalis (HF), accounting for around 95% of cases. It associates high perinatal mortality and morbidity rates. The aim of the study was, first, to investigate etiology, prenatal management, and perinatal outcome in a large single-center series of HF; second, to identify prenatal prognostic factors with impact on perinatal outcome. Materials and Methods: Observational retrospective study of 80 HF diagnosed or referred to a single tertiary center between 2012 and 2021. Clinical characteristics, etiology, prenatal management, and perinatal outcome were recorded. Adverse perinatal outcome was defined as intrauterine fetal death (IUFD), early neonatal death (first 7 days of life) and late neonatal death (between 7 and 28 days). Results: Seventy-six of the 80 cases (95%) were NIHF, main etiology being genetic disorders (28/76; 36.8%). A total of 26 women (32.5%) opted for termination of pregnancy, all of them in the NIHF group. IUFD occurred in 24 of 54 patients (44.4%) who decided to continue the pregnancy. Intrauterine treatment was performed in 29 cases (53.7%). There were 30 newborns (55.6%). Adverse perinatal outcome rate was 53.7% (29/54), significantly higher in those diagnosed <20 weeks of gestation (82.4% < 20 weeks vs. 40.5% >= 20 weeks; p = 0.004). Survival rate was higher when fetal therapy was performed compared to the expectantly managed group (58.6% vs. 32%; p = 0.05). Intrauterine blood transfusion and thoraco-amniotic shunt were the procedures that achieved the highest survival rates (88.9% and 100%, respectively, p = 0.003). Conclusion: NIHF represented 95% of HF with genetic disorders as the main etiology. Most of them were diagnosed before 20 weeks of gestation, with worse prognosis than cases detected later in gestation. Rates of TOP, IUFD, and early neonatal death were higher in NIHF. Intrauterine therapy, when indicated, improved the perinatal outcome. (c) 2024 S. Karger AG, Basel

Non-immune hydrops fetalis (NIHF) is a rare entity characterized by excessive accumulation of fluid within the fetal extravascular compartments and body cavities. Here we present two intrauterine fetal demises with NIHF presenting with oligohydramnios, cystic hygroma, pleural effusion, and generalized hydrops with predominance of subcutaneous edema. The fetuses also presented with ascites, severe and precocious IUGR and skeletal anomalies. Whole exome sequencing was applied in order to screen for a possible genetic cause. The results identified biallelic variants in MYBBP1A in both fetuses. A previous report described another case with a similar phenotype having compound heterozygous variants in the same gene. The protein encoded by MYBBP1A is involved in several cellular processes including the synthesis of ribosomal DNA, the response to nucleolar stress, and tumor suppression. Our functional protein analysis through immunohistochemistry indicates that MYBBP1A is a gene expressed during fetal stages. Altogether, we concluded that MYBBP1A is associated with the development of hydrops fetalis. More cases and further studies are necessary to understand the role of this gene and the mechanism associated with NIHF.

ObjectiveThis document addresses the clinical application of next-generation sequencing (NGS) technologies for prenatal genetic diagnosis and aims to establish clinical practice recommendations in Spain to ensure uniformity in implementing these technologies into prenatal care.MethodsA joint committee of expert obstetricians and geneticists was created to review the existing literature on fetal NGS for genetic diagnosis and to make recommendations for Spanish healthcare professionals.ResultsThis guideline summarises technical aspects of NGS technologies, clinical indications in prenatal setting, considerations regarding findings to be reported, genetic counselling considerations as well as data storage and protection policies.ConclusionsThis document provides updated recommendations for the use of NGS diagnostic tests in prenatal diagnosis. These recommendations should be periodically reviewed as our knowledge of the clinical utility of NGS technologies, applied during pregnancy, may advance.

Background Advances in haemolytic disease of the fetus and newborn have led to numerous treatment options. We report practice variations in the management and outcomes of haemolytic disease of the fetus and newborn in at-risk pregnancies. Methods In this international, retrospective, observational cohort study, data from cases with moderate or severe haemolytic disease of the fetus and newborn were retrieved from 31 centres in 22 countries. Eligible participants had pregnancies with haemolytic disease of the fetus that led to fetal death at 16 + 0 weeks or later, those treated antenatally with intrauterine transfusion or intravenous immunoglobulins, or neonates without antenatal treatment who were treated with intensive phototherapy, exchange transfusion, or red blood cell transfusions. All patients had confirmed maternal alloantibodies and an antigen-positive fetus incompatible with the maternal alloantibody. Patients with ABO-incompatibility only were excluded. We assessed serological diagnostics and referrals, antenatal treatment and timing, complications, delivery route, and gestational age at birth. Outcomes were analysed in all eligible participants who had complete data available. Findings 2443 pregnancies with haemolytic disease of the fetus and newborn treated between Jan 1, 2006, and July 1, 2021, were shared by the centres and analysed between Dec 1, 2021, and March 1, 2023. 23 pregnancies were excluded due to missing information and we included 2420 for further analysis. 1764 (72 center dot 9%) of 2420 pregnancies were affected by D-antibodies. 95 (3 center dot 9%) of 2420 pregnancies resulted in fetal death. Of the 2325 liveborn neonates, 1349 (58 center dot 1%) received any form of antenatal treatment and 976 (41 center dot 9%) were only treated postnatally. Median gestational age at referral was 20 center dot 4 weeks (IQR 14 center dot 9-28 center dot 0) and ranged between medians of 10 center dot 0 and 26 center dot 3 weeks between centres. Severe hydrops at first intrauterine transfusion was present in 185 (14 center dot 5%) of 1276 pregnancies, with proportions ranging between 0 and 42% between centres. A median of two intrauterine transfusions (IQR 1-4) were done per pregnancy. The fetal access sites used in intrauterine transfusions varied widely between centres. Nonlethal complications in intrauterine transfusions by transfusion site occurred at a lower rate in intrahepatic approaches (2 center dot 0%, 95% CI 1 center dot 1-3 center dot 3) than in placental insertion (6 center dot 9%, 5 center dot 8-8 center dot 0) and free loop (13 center dot 3%, 8 center dot 9-18 center dot 9). The use and indication for intravenous immunoglobulin administration varied widely. Neonates with intrauterine transfusion were born at a median gestational age of 35 center dot 6 weeks (IQR 34 center dot 0-36 center dot 7), ranging between medians of 33 center dot 2 and 37 center dot 3 weeks between centres, while neonates without antenatal treatment were born at a median gestational age of 37 center dot 3 (IQR 36 center dot 3-38 center dot 1), ranging between medians of 34 center dot 9 and 38 center dot 9 weeks between centres. Interpretation We found considerable variation in antenatal management and outcomes in haemolytic disease of the fetus and newborn between sites in different countries. Our study shows the capacity of the field to gather valuable data on a rare disease and to optimise care. Copyright (c) 2024 Elsevier Ltd. All rights reserved, including those for text and data mining, AI training, and similar technologies.

Introduction: Fetal anemia from hemolytic disease treated by intrauterine transfusion (IUT) can be performed by intraperitoneal, intracardiac, and intravascular transfusion (IVT). Objective of our study was to compare different transfusion techniques. Methods: Retrospective review of IUT secondary to red cell alloimmunization was conducted at eight international centers from 2012 to 2020. Severe anemia suspected if middle cerebral artery peaks systolic velocity ≥1.5 multiples of the median. Demographic, delivery, and postnatal variables were analyzed. Results: Total of 344 procedures, 325 IVT and 19 other techniques (non-IVT) included. No difference in demographics, history of stillbirth (20.5 vs. 15.8%, p = 0.7), prior pregnancy IUT (25.6 vs. 31.6%, p = 0.5) or neonatal transfusion (36.1 vs. 43.8%, p = 0.5). At first IUT, non-IVT had higher hydrops (42.1% vs. 20.4%, p = 0.03), lower starting hematocrit (13.3% [±6] vs. 17.7% [±8.2], p = 0.04), and trend toward lower gestational age (24.6 [20.1–27] vs. 26.4 [23.2–29.6] weeks, p = 0.08). No difference in birthweight, neonatal phototherapy, exchange, or simple transfusion was observed. Conclusion: This is one of the largest studies comparing techniques to treat fetal anemia. IVT was most performed, other techniques were more likely performed in hydrops, and lower starting hematocrit was seen. Neither technique affected outcomes. This study may suggest that physician’s experience may be the strongest contributor of outcomes.

Epidermolysis bullosa is a rare hereditary autosomal disease that is included in the heterogeneous group of genodermatosis. It is characterized by skin and mucous membranes fragility and denudation, and it can be associated with pyloric atresia. Prognosis is often poor, and death can occur in neonatal period due to severe sepsis. We present a case of fetal junctional epidermolysis bullosa in a consanguineous couple, highly suggested by previous obstetric history and several antenatal ultrasound signs, such as polyhydramnios, gastric enlargment, the "snowflake sign", abnormal external ears, signs of skin desquamation, lower limbs anomalies and chorioamniotic membrane separation. We describe a marked perioral hipoecogenicity as a novel sign of skin-mucous denudation, which could be helpful for future diagnosis. A review of literature, focused specifically on the antenatal sonography role, is also reported. Prenatal ultrasound-based diagnosis of epidermolysis bullosa is difficult, especially in apparently low risk contexts, but may be possible.

Introduction: Uterine arteriovenous malformations (UAVM) usually present as vaginal bleeding in women of childbearing age. Obstetric or uterine surgical history and ultrasound are key when suspecting this pathology. There are multiple treatments available, including medical surgery or interventional radiology with different effectiveness.Material and methods: We analysed the diagnosis and management of three patients with epi-sodes of vaginal bleeding and obstetric history, or uterine surgeries with a MAVU diagnosis.Results: In the three cases analysed, medical treatment was provided as first line treatment. After the failure of medical treatment with oral gestagens, methylergometrine, or tranexamic acid, transarterial embolization was performed with occlusion of the nidus or fistula point.Conclusions: Based on our experience, due to the delay between diagnosis and the wide variety of MAVU treatments, supraselective embolization could be assessed as one of the treatments with the highest rate of efficacy in a patient profile that has usually not fulfilled their repro-ductive desire. Although the short-term results do not seem to affect fertility, it is important to prospectively follow-up these patients regarding achievement of a new pregnancy or recurrence of MAVU.& COPY; 2022 Elsevier Espana, S.L.U. All rights reserved.

Las malformaciones arteriovenosas uterinas (MAVU) generalmente se presentan como sangrado vaginal en mujeres en edad fértil. Los antecedentes obstétricos o quirúrgicos uterinos y la ecografía son clave para la sospecha de esta dolencia. Existen múltiples tratamientos disponibles tanto médicos como quirúrgicos, con efectividad diversa. Analizamos el proceso diagnóstico y terapéutico de 3 pacientes con episodios de metrorragias y antecedentes obstétricos o cirugías uterinas que presentaban MAVU. En los 3 casos analizados, se realizó tratamiento médico como primera elección. Tras el fracaso del tratamiento médico mediante gestágenos orales, metilergometrina o ácido tranexámico, se realizó embolización transarterial con oclusión del nido o punto de la fístula. Con base en nuestra experiencia, debido a la demora entre el diagnóstico y la amplia variedad de tratamientos de las MAVU, la embolización supraselectiva podría valorarse como uno de los tratamientos con mayor tasa de eficacia en un perfil de paciente que habitualmente no ha completado su deseo genésico. Aunque los resultados a corto plazo parece que no afectan a la fertilidad, sería importante realizar un seguimiento prospectivo de estas pacientes en lo que respecta a la consecución de nueva gestación o recidiva de MAVU. Uterine arteriovenous malformations (UAVM) usually present as vaginal bleeding in women of childbearing age. Obstetric or uterine surgical history and ultrasound are key when suspecting this pathology. There are multiple treatments available, including medical surgery or interventional radiology with different effectiveness. We analysed the diagnosis and management of three patients with episodes of vaginal bleeding and obstetric history, or uterine surgeries with a MAVU diagnosis. In the three cases analysed, medical treatment was provided as first line treatment. After the failure of medical treatment with oral gestagens, methylergometrine, or tranexamic acid, transarterial embolization was performed with occlusion of the nidus or fistula point. Based on our experience, due to the delay between diagnosis and the wide variety of MAVU treatments, supraselective embolization could be assessed as one of the treatments with the highest rate of efficacy in a patient profile that has usually not fulfilled their reproductive desire. Although the short-term results do not seem to affect fertility, it is important to prospectively follow-up these patients regarding achievement of a new pregnancy or recurrence of MAVU.

IntroductionThe aims of the study were to evaluate perinatal outcome in monochorionic (MC) twins complicated with single intrauterine fetal death, spontaneously versus after fetal therapy, and to assess antenatal events that increase the risk of cerebral injury. Material and methodsHistorical cohort study of MC pregnancies with single intrauterine fetal death diagnosed or referred to a tertiary referral hospital (2012-2020). Adverse perinatal outcome included termination of pregnancy, perinatal death, abnormal fetal or neonatal neuroimaging and abnormal neurological development. ResultsA total of 68 MC pregnancies with single intrauterine fetal death after 14 weeks of gestation were included. Sixty-five (95.6%) occurred in complicated MC pregnancies (twin to twin transfusion syndrome: 35/68 [51.5%]; discordant malformation: 13/68 [19.1%], selective intrauterine growth restriction: 10/68 [14.7%], twin reversed arterial perfusion sequence: 5/68 [7.3%] and cord entanglement in monoamniotic twins: 2/68 [2.94%]). In 52 cases (76.5%) single intrauterine fetal demise occurred after fetal therapy and in 16 (23.5%) occurred spontaneously. Cerebral damage included 14/68 cases (20.6%): 6/68 cases (8.82%) were prenatal lesions and 8/68 cases (11.8%) were postnatal. Risk of cerebral damage tended to be higher in the spontaneous death group (6/16, 37.5%) compared to the therapy-group (8/52, 15.38%) (p = 0.07). The risk increased with gestational age at intrauterine death (OR 1.21, 95% CI: 1.04-1.41, p = 0.014) and was higher in those surviving co-twins who developed anemia (OR 9.27, 95% CI: 1.50-57.12, p = 0.016). Pregnancies complicated with selective intrauterine growth restriction tended to be at higher risk for neurological damage (OR 2.85, 95% CI: 0.68-11.85, p = 0.15). Preterm birth rate (<37 weeks of pregnancy) was 61.7% (37/60). Seven of eight postnatal cerebral lesions (87.5%) were related to extreme prematurity. Overall perinatal survival rate was 88.3% (57/68) and 7% (4/57) of children had an abnormal neurological outcome. ConclusionsRisk of cerebral damage in single intrauterine fetal death is especially high when it occurs spontaneously. Gestational age at single intrauterine fetal death, selective intrauterine growth restriction and anemia of the surviving co-twin are the main predictors for prenatal lesions and might be useful in parent counseling. Abnormal postnatal neurological outcome is closely related to extreme prematurity.

Mitochondrial fatty acid oxidation (FAO) is lower in placentas with pre-eclampsia. The aim of our study was to compare the placental mRNA expression of FAO enzymes in healthy pregnancies vs. different subgroups of pre-eclampsia according to the severity, time of onset, and the presence of intrauterine growth restriction (IUGR). By using real-time qPCR, we measured the mRNA levels of long-chain 3-hydroxyacyl-CoA dehydrogenase (LCHAD), medium-chain acyl-CoA dehydrogenase (MCAD), and carnitine palmitoyltransferases 1A and 2 (CPT1A, CPT2) on the maternal side (anchoring villi in the basal decidua) and on the fetal side (chorionic plate) of the placenta (n = 56). When compared to the controls, LCHAD, MCAD, and CPT2 mRNA had decreased in all pre-eclampsia subgroups globally and on the fetal side. On the maternal side, LCHAD mRNA was also lower in all pre-eclampsia subgroups; however, MCAD and CPT2 mRNA were only reduced in severe and early-onset disease, as well as CPT2 in IUGR (p < 0.05). There were no differences in CPT1A mRNA expression. We conclude that the FAO enzymes mRNA in the placenta was lower in pre-eclampsia, with higher reductions observed in severe, early-onset, and IUGR cases and more striking reductions on the fetal side.

Background: Tubal patency testing constitutes an essential part of infertility work-up. Hysterosalpingo-foam-sonography (HyFoSy) is currently one of the best tests for assessing tubal patency. The objective of our study was to evaluate the post-procedure rate of spontaneous pregnancy among infertile women submitted for an HyFoSy exam with ExEm® foam and the factors associated with this. Methods: Multicenter, prospective, observational study performed at six Spanish centers for gynecologic sonography and human reproduction. From December 2015 to June 2021, 799 infertile women underwent HyFoSy registration consecutively. The patients’ information was collected from their medical records. Multivariable regression analyses were performed, controlling for age, etiology, and time of sterility. The main outcome was to measure post-procedure spontaneous pregnancy rates and the factors associated with the achievement of pregnancy. Results: 201 (26.5%) women got spontaneous conception (SC group), whereas 557 (73.5%) women did not get pregnant (non-spontaneous conception group, NSC). The median time for reaching SC after HyFoSy was 4 months (CI 95% 3.1–4.9), 18.9% of them occurring the same month of the procedure. Couples with less than 18 months of infertility were 93% more likely to get pregnant after HyFoSy (OR 1.93, 95% CI 1.34–2.81; p < 0.001); SC were two times more frequent in women under 35 years with unexplained infertility (OR 2.22, 95% CI 1.07–4.65; P0.033). Conclusion: After HyFoSy, one in four patients got pregnant within the next twelve months. Couples with shorter infertility time, unexplained infertility, and women under 35 years are more likely to achieve SC after HyFoSy.