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Created by gynecologists for an improved doctor patient experience
ExEm® Foam used during the HyFoSy procedure was developed by Dutch gynecologists Dr. Niek Exalto and Prof. Dr. Mark Hans Emanuel. The root name “ExEm” is derived by combining the two first letters of the product inventors’ last names, ExEm Foam, Drs. Exalto and Emanuel. Both Dr. Exalto and Prof. Dr. Emanuel envisioned an easier, less-invasive tubal patency procedure with better visualization capabilities, without the burdens which come with HSG (e.g. use of X-ray and iodine, and the need for an additional appointment). First launched in Europe in 2011, ExEm® Foam has been used in over 1 million fallopian tubes worldwide, providing a safe, successful alternative to X-ray HSG, laparoscopy or saline and air.

Tubal patency assessment procedures timeline

1910
Laparoscopy: Jacobaeus (1910), Palmer (1947).
1966
Emergence of ultrasound based techniques with saline infusion sonography (SIS) (Corfman and Taylor).
2011
Introduction of Hysterosalpingo Foam Sonography (HyFoSy) (Exalto and Emanuel), an in-office procedure for tubal patency testing in women with known or suspected infertility or subfertility. ExEm® Foam is the medium used in HyFoSy.
2022
HyFoSy, the future of tubal patency assessment.
The foam study, a large randomized control study found that HyFoSy leads to similar pregnancy outcomes, compared with HSG as first-choice patency test. Then it also found that HyFoSy is experienced as significantly less painful than HSG.3
1914
First HSG is performed (Carey).
1993
Introduction of Hysterosalpingo Contrast Sonography (HyCoSy) (Deichert), a patient friendly ultrasound technique. However, the common contrast medium Echovist® (Schering AG, Berlin, Germany) was taken out of market and replaced by saline and air. Saline and air which accuracy is not comparable to HSG, is now the mostly used alternative.2
2017
HyFoSy proven accuracy and minimum invasiveness. Studies suggested that, with proper imaging technique, HyFoSy with ExEm® Foam does not significantly differ from laparoscopy with dye and has the ability to achieve significantly higher accuracy than 2D saline and air1.
Learn more about ExEm® Foam
Give your patients with known or suspected infertility the option of an innovative and gentle tubal patency assessment.
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Here's what patients and doctors say

Over a half-million patients around the world have experienced a tubal patency procedure with ExEm Foam.
Here is some of their feedback:

❝Trying to conceive brings enough insecurities. Having the doctor explain the test results and discuss the next step in my fertility journey straight away, gave me clarity and reduced anxiety❞.
_PATIENT TESTIMONIAL
❝Trying to conceive brings enough insecurities. Having the doctor explain the test results and discuss the next step in my fertility journey straight away, gave me clarity and reduced anxiety❞.
_PATIENT TESTIMONIAL
❝Trying to conceive brings enough insecurities. Having the doctor explain the test results and discuss the next step in my fertility journey straight away, gave me clarity and reduced anxiety❞.
_PATIENT TESTIMONIAL
Contraindications

• Do not use the gel foam during pregnancy.
• Do not use the gel foam if the patient may be pregnant.
• Do not use the gel foam between ovulation and menstruation.
• Do not use the gel foam in the presence of active pelvic infection, sexually transmitted diseases and profuse bleeding.
• Do not use the gel foam in case of allergy to any of the constituents of ExEm® Gel (hydroxyethylcellulose, glycerol and purified water).

Precautions and warnings:

• The ExEm® Foam Kit should be considered as contaminated medical waste after use.
• Do not use if package has been previously opened or damaged.
• This device is intended for single use only. Any foam not used in one examination session must be discarded.
• Do not reuse, re-sterilize or autoclave. Reuse of single use devices creates a potential risk of patient or user infections. Contamination of the device may lead to injury, illness or death of the patient. Cleaning, disinfection and sterilization may compromise essential material and design characteristics leading to device failure. The manufacturer will not be responsible for any direct, incidental or consequential damages resulting from re-sterilization or reuse.
• Do not use the ExEm® Foam Kit after the expiry date of the ExEm® Gel, the ExEm® Water, the coupling device and/or the GIS catheter.
• Do not use the ExEm® Gel and the ExEm® Water separately for Hysterosalpingo Sonography.
• The ExEm® Gel and the ExEm® Water are not to be used for injections.
Note Some patients may experience painful uterine contractions, vasovagal reaction, abdominal pain, fluid loss or spotting. These symptoms are well known and related to all intra-uterine and tubal patency testing procedures. Pain treatment should be according to local protocol.