A comparison of pain experienced during hysterosalpingography and in-office falloposcopy

To determine patient perception of the intensity of pain during in-office falloposcopy compared with hysterosalpingography (HSG). A prospective quality assurance study using a formal pain scale to compare two procedures. Patients attending a tertiary level infertility clinic. In-office falloposcopy or HSG using analgesics. The mean pain score and area under the pain curve experienced during each investigation. Using our technique, in-office falloposcopy was associated with a significantly lower mean intensity of pain and with a longer procedure. The duration of the falloposcopic examination declined significantly with physician experience. Flushing adjacent to the uterotubal ostium, ostial cannulation, and rapid eversion provoked episodes of acute pain during falloposcopy. These results support the patient acceptability of in-office falloposcopy.