Tubal patency tests are undertaken when the doctors suspect that there are blockages or pelvic adhesions in the fallopian tubes. These tests include procedures like Gas Insufflation, Hysterosalpingography (H.S.G.), Laparoscopy, etc.

What is the Role of the Fallopian Tubes in Initiating Pregnancy?

Healthy fallopian tubes are an essential pre-requisite for conception to occur. If the tubes are completely blocked, the sperm are unable to reach the egg to fertilize it.  If however, the tubes are damaged and not completely blocked, the sperm may be able to reach the egg, but the early embryo is more likely to be trapped in the distorted tube - a dangerous condition known as an ectopic pregnancy. Thus it is not enough that the sperm have access to the egg. It is also necessary that the egg must not be prevented from reaching the open end of the tube. If the ovaries are surrounded by adhesions, there is a major barrier between egg and sperm. 

What are the Causes of Tubal Obstruction?

The primary cause of tubal obstruction and pelvic adhesions is infection. Infection can be caused by peritonitis from acute appendicitis, or it may have arisen within the uterus itself as a complication of a previous termination of pregnancy, miscarriage or difficult delivery. In addition, there are a number of women who have chosen sterilization as a means of permanent birth control and change their minds for a variety of reasons.   

Is it common for women to have a problem with their tubes?

About 15% of women attending an infertility clinic will have a tubal problem. A perusal of the medical history of half of these women will show no past history of any probable cause for their damaged tubes. In such cases it is possible that a viral infection, even one caught in childhood, has been responsible for the damage.  If there are no indications in your history that the tubes may be blocked, you will in all likelihood be given the benefit of the doubt initially while other causes of infertility are investigated. If, however, there is a definite past history indicating possible tubal obstruction, a test of tubal patency will be carried out at a relatively early stage.  

There are three common tubal patency tests

• Gas Insufflation
• Hysterosalpingography (H.S.G.) 
• Laparoscopy 

Minimally Invasive Reproductive Surgery

Laparoscopic and hysteroscopic procedures are among the options available to treat various reproductive disorders, including:

• tubal reconstruction, repair and tubal-ligation reversal

• repair and reconstruction of intrauterine abnormalities

• removal of endometrial tissue due to dysfunctional bleeding that is not responsive to medical therapy

• uterine fibroids

Most procedures, including the latest in laser surgery, are performed on an outpatient basis. Benign and malignant pathology affecting the reproductive tract can cause clinical symptoms and challenge a woman’s ability to initiate and maintain a pregnancy. Gynecologic surgery specifically aimed at restoring or maintaining reproductive function is called reproductive surgery. Among gynecologic surgeons, those who specialize in reproductive endocrinology and infertility are specifically trained to be attentive to a woman’s future reproductive needs. Reproductive surgeons are specifically skilled at minimally invasive surgical techniques such as laparoscopy and hysteroscopy, and consistently adopt the principles of microsurgical technique to minimize any negative impact of surgery on reproduction.

The skills of reproductive surgeons may extend to procedures not necessarily aimed at maintaining reproductive function, but allow the procedures to be undertaken in a minimally invasive day-surgery setting. This is the case for example for laparoscopic hysterectomy or oophorectomy.

The Indications are:

• Endometriosis
• Ovarian cysts
• Ectopic pregnancy
• Pelvic adhesions
• Regret of tubal sterilization
• Congenital malformations
• Uterine fibroids
• Uterine polyps