Background: Fallopian tubes patency assessment can be done using a number of methods involving hysterosalpingography, laparoscopy and hysterosalpingo-contrast sonography which can be done as an office setting and also for the uterine cavity assessment.
Objectives: To compare HyFoSy versus HSG in tubal patency assessment in patients without obvious cause of infertility and the incidence of spontaneous pregnancy in the 3-months post procedure. 
Patients and methods: This randomized controlled trial was conducted on subfertile women who were referred to the outpatient clinics at Obstetrics and Gynecology department, South Valley University. We included 300 women, randomized into one of 3 groups. Group A had HyFoSy, Group B had HSG and Group C had only follow up without testing. We compared both procedures regarding ease, cost, pain using the visual analogue scale, complications and occurrence of pregnancy within 3 months.
Results: Our groups were comparable regarding age, BMI, type of infertility and previous pelvic surgeries.Cervical cannulation was easier in the HyFoSy group with shorter procedure time, less amount of contrast material and less pain. In both groups complications were self-limiting and managed as outpatients. After 3 months,the incidence of pregnancy among the final cases completed the study was (23.7%) in the HyFoSy group, (16.5%) in the HSG group & (10.5%) in the control group without significant statistical difference between them.
Conclusion: HyFoSy is an effective outpatient method to assess tubal patency with shorter procedure time, less pain, less cost, less amount of injected contrast material, slightly higher pregnancy rates without significant complications compared to HSG.