 Hello friends, I hope you like the first part of the video on Sonosalpingography using Sonoview, showing the normal delineation of the fallopian tubes. In this second part, let us see some abnormal cases and also advantages over X-ray-based salpingography and saline. This is a case with the history of primary infertility of more than two years. The adenic sap here clear and a small cyst seen in the left ovary. Injection of the Sonoview contrast agent showed this cyst in the left ovary which was filled up with a contrast medium. So what we thought of as a cyst was actually a hydrosalping and in fact there is a hydrosalping on the right side as well which was not seen on 2D examination and we can see here bilateral hydrosalpings and with the contrast persisting within the hydrosalpings. This is a delayed post-contrast study after about five minutes which still showed the contrast within the hydrosalpings. This is another case of a left hydrosalpings showing a beaded appearance. This is the terminal fallopian tube and a delayed spill was seen after about five to eight minutes and a delayed pereovirian diffusion. In this case you can see the contrast flowing in the right fallopian tube right up to the fibril end and an immediate spill but on the left side there is no flow of the contrast beyond the conial end suggestive of a left conial block. This is a case with history of three failed IUI and normal bilateral spill was seen in both the adenic which showed that the fallopian tubes were patent. An examination of the endometrial canal after installation of saline showed presence of thick sine decay within it which was the cause of the infertility and the failed IUI. This is another case with thick sine decay within the uterine cavity and this is an endometrial polyp which was not seen on the 2D examination and which was a cause of infertility. So the advantages of sonovu over HSG and also saline are that the fallopian tubes are very well delineated with sonovu. The morphology of the tubes can also be evaluated especially with 3D reconstruction. Bilateral corneal spasm and pain is a limitation but this was much less with sonovu as compared to saline and even HSG because very small quantity of contrast as small as 2CC was enough to evaluate the tubes and also the spill. It is expensive costing about 6,000 rupees for an ampoule but it can be cost effective if 2 to 3 patients can be pulled in at the same time because just 2CC is enough to delineate the fallopian tubes. Large studies have reported that 3D histero contrast salpingography is a safe outpatient procedure, highly accurate with 100% sensitivity, 67% specificity, 89% positive predictive value and 100% negative predictive value for tubal patency and about 91% concordance rate with laparoscopy. So in conclusion SSG with sonovu is an accurate method for determination of fallopian tube patency but is highly operator dependent. It has a high positive and negative predictive value. It is a simple OPD procedure for initial work up of patients with infertility. Invasive diagnostic laparoscopy can be avoided if the tubes are patent and can be used in only selective patients. Mild to moderate pain was seen in some of our patients but well tolerated and there was no vasovagal reaction or any infection in any of our patients. It has a therapeutic effect also as some of our patients conceived after the procedure especially after the flushing of the fallopian tubes. The uterine cavity, the ovaries and the attic sac can be evaluated for other abnormalities as well and it helps in management decisions whether IUI or IVF should be used. Thank you.