Exploring Fallopian Tube Health: Diagnostic and Therapeutic Insights – ARC Summit

One common method to verify if the fallopian tubes are open, a crucial factor in infertility, is through a hysterosalpingogram (HSG). This diagnostic and potentially therapeutic procedure involves flushing the fallopian tubes, which can help remove mucus blockages and has been shown to temporarily increase fertility by about six months. However, the use of fluoroscopy in this process exposes patients to radiation, so exposure is minimized as much as possible.

During an HSG, a radio-opaque contrast dye is used to outline the uterine cavity and fallopian tubes. A normal HSG shows the dye passing freely through both tubes. In contrast, an abnormal HSG might reveal blocked fallopian tubes, resembling a water balloon due to expansion and lack of dye diffusion. For instance, in cases of a prior infection such as Chlamydia, the dye may be cut off at the blockage point, causing the tubes to expand and appear sacculated.

At laparoscopy, a closed tube can be observed as early filling of a hydrosalpinx, where the fimbrial ends are agglutinated, and the tube expands significantly. In such cases, the tube might be surgically removed. This is because fluid accumulating in a blocked fallopian tube can leak back into the uterus, potentially preventing embryo implantation by coating the endometrial surface, thereby reducing fertility.

To avoid radiation exposure, we also offer a procedure known as HyCoSy (hysterosalpingo-contrast sonography), which uses a mixture of air and water infused through the fallopian tubes during an ultrasound. This non-radiographic method allows us to observe the passage of the mixture through the tubes to assess their openness. This is akin to what we might do during laparoscopy but offers a non-invasive way to check tube patency.