Tubal patency assessment
The Fallopian tubes are tubes that guide the egg from the ovary to the uterus. To obtain a pregnancy, the Fallopian tubes must be open or patent. Tubal assessment may be recommended in some women who are having difficulty conceiving. Normal Fallopian tubes can not be seen on a regular ultrasound but a contrast medium can be used to demonstrate the Fallopian tubes.
When should the test be performed?
The test should be performed in the first half of your cycle before you ovulate. We recommend that you ring one of our practices on the first day of your period (=day 1 of the cycle) and book the appointment for day 7 to day 10 of that cycle. Our staff can assist you with the right time for your appointment.
Once you ovulate you are potentially pregnant. We would not take the risk of injecting a fluid in the uterus after ovulation, even if the chance of pregnancy is low. The test is therefore postponed to the next cycle if we note on the initial ultrasound that you have already ovulated.
Is the test painful?
The pain experienced during the test is very variable. Some women feel absolutely no pain, while other women feel significant cramping of the uterus when the contrast is injected. It is therefore difficult to tell you what to expect but it would be fair to say that the majority of women feels mild to moderate discomfort during the procedure. The pain is comparable to serious period-like cramping. We are guided by what you feel so it is important that you let the doctor know when you experience pain.
Because pain and cramping may occur during the test, we recommend that you take a pain killer like Naprosyn or Nurofen (2 tablets) approximately 1 hour before the procedure. Although most women feel fine after the procedure, you may consider bringing a friend to drive you home and arrange to have the rest of the day off work.
The contrast medium
One of two different contrast media are used : Ex Em Foam and Definity.
A vaginal ultrasound is performed first to assess the pelvic anatomy.
If there is proof of ovulation in the current cycle, the tubal assessment is postponed to the next cycle. If the ultrasound shows an abnormality that needs assessment by the referring doctor first, the procedure may not be performed. If the ultrasound findings are normal and consistent with the first half of the cycle, tubal assessment is performed.
The vagina is disinfected with an antiseptic solution.
A speculum is placed in the vagina like for a PAP smear and the cervix is visualised.
A special catheter with a small 'pea' size balloon at the tip is inserted through the cervix. Once the balloon is correctly positioned in the uterine cavity, the speculum is removed and the vaginal probe is inserted in the vagina.
The contrast medium is then prepared and injected through the catheter and the tubes are examined. Contrast should be seen flowing through the Fallopian tube and spilling around the ovary on both sides.
When spilling is seen on both sides, it can be concluded that the Fallopian tubes are patent. When the Fallopian tubes can not be seen, it can not always be concluded that they are blocked as spasm of the uterus can temporarily occlude the opening of the Fallopian tubes. In that case, the referring doctor will organise further tubal assessment.
The doctor who performs the examination will discuss the results with you during and after the examination. Don't hesitate to ask questions. A written copy of the result is sent in the mail and should reach your doctor 2 days after your ultrasound. Please advise us if you see your doctor earlier than that so we can fax the results.