 Hello friends my name is Dr. Geeta Shah and I'm going to talk about a novel technique of doing sonosalpingography using sonovu for assessing the fallopian tubes. Tubal factors account for about 30 to 35% of causes of infertility mainly due to pelvic inflammatory disease, endometriosis, salpingitis, peritubal infections, any history of past surgeries and congenital uterine abnormalities. The common methods that have been used to assess the tubal patency are histrosalpingography which is X-ray based and using iodinated contrast medium with its known side effects. Sonosalpingography using saline and now the newer contrast agent sonovu using micro bubbles and laparoscopy with dye which is the gold standard but it is invasive. The basic principle of ultrasound contrast media is that they act as echo enhancers. Insolation of the echo enhancing contrast agents with high acoustic power produces disintegration of micro bubbles and that results in stimulated acoustic emission and all the positive ultrasound contrast media are developed based on this very principle. We use the sonovu contrast agent which is a second generation sulphur hexafluoride microparticles. It is reconstituted with five cc of novel saline. We use the the Voluson E8 machine with contrast settings. One cc of the reconstituted contrast agent was diluted in four cc of saline which was injected in the uterine cavity. The case selection criteria was patience with history of primary and secondary infertility for more than a year. It was performed in the follicular phase between the seventh to the eleventh day of menstrual cycle. A painkiller and an antispasmodic such as tablet meftal spas was given one hour prior to the procedure. Intramuscular atropine was given 30 minutes before the procedure and prophylactic antibiotic augmentin of course for three days was also given. We use the six to eight French SSG catheter with an inflated balloon. This was introduced in the uterine cavity using strict aseptic precautions and this is the image of the inflated balloon in the uterine cavity. This is showing the contrast agent sonovu within the left fallopian tube and we can trace it right up to its femoral end close to the ovary and we can see the active spill here and this is the left ovary and we can see the periovarian diffusion. This is the right fallopian tube showing the smooth balls and the femoral end and the right periovarian diffusion. This is a 3d reconstruction the right fallopian tube and periovarian diffusion and the left fallopian tube the left periovarian diffusion. This is an example of sonosalpingography using saline just to use as a comparison and the saline is injected in the endometrial cavity and immediate spill is seen. Some amount of collection is also seen in the Latinxa so we can comment about the patency of the fallopian tube but we cannot see or delineate the fallopian tubes.