tubal-patency-tests

Tubal Patency Tests

Tubal patency tests can check for blockages in the fallopian tubes that could be preventing you from getting pregnant. Blocked fallopian tubes are a common cause of female infertility, but it is possible to overcome this issue with IVF treatment.

What are Tubal Patency Tests?

Tubal patency tests are a special kind of scan that may be recommended as part of a female fertility assessment. It can detect some of the common causes of female infertility so that your doctors can make the right recommendations for treatment. The scan may reveal treatable fertility problems or show whether you are a good candidate for IVF treatment.

The tubal patency test is one of the checks that you might have during a fertility assessment if you’re concerned about your fertility or considering IVF treatment. The test will check for any blockages in your fallopian tubes. The fallopian tubes connect your ovaries to the uterus. When a mature egg is released from the ovary at ovulation, it will start moving along the fallopian tube. During natural collection, the sperm will swim up through the womb and the conception will actually take place in the fallopian tube. The fertilised egg will then move down the tube and into the womb. Any blockages in the fallopian tube could prevent the egg and sperm from meeting or make it harder for the egg to make its way to the womb.

The tubal patency test can check for any blockages in the fallopian tubes using a special kind of dye that will show up on the scans. When the fallopian tubes are clear and healthy, the dye should be visible as it passes all the way along them. If something prevents the dye from moving freely then it means that the eggs and sperm may also be blocked.

Who Should Have Tubal Patency Tests?

The tubal patency test may be recommended if you are having a fertility assessment to find out why you have been having trouble conceiving naturally. It is often performed for women who are considering having IVF. Blockages in the fallopian tubes are one of the fertility problems that can be treated with IVF as the egg and sperm will be brought together outside of the body, without having to travel along these tubes. As long as there are no other issues (such as the quality or availability of eggs or male fertility problems) then IVF can often be very successful at treating infertility due to fallopian tube blockages.

If you have had an STI, pelvic inflammatory disease, endometriosis or an ectopic pregnancy in the past then your doctor may recommend a surgical procedure called laparoscopy to check on your fallopian tubes instead of the fallopian patency test. A laparoscopy may also be recommended to learn more about any blockages that have been discovered during a tubal patency test.

What is Involved?

A tubal patency test is a type of X-ray that uses a special dye to see how clear the fallopian tubes are. Although this test is very safe, you may feel a bit uncomfortable as the dye is introduced. A speculum will be used to open up the vagina, in the same way as during a cervical smear test. A thin tube will then be inserted through the vagina and cervix into the womb. The dye will be released into the womb and it will make its way along the fallopian tubes. A series of X-rays will be taken while this is happening so that the dye can be tracked. If there are any blockages, then the dye won’t be able to move freely along the fallopian tubes. The X-rays will show where the dye stopped or was slowed down.

A different type of scan known as hysterosalpingo-contrast-sonography or HyCoSy can also be used to check the fallopian tubes without having to use a radioactive dye or X-rays. A different type of dye will be introduced into the uterus and allowed to travel along the fallopian tubes. The dye used during HyCoSy will show up on ultrasound scans, so a trans-vaginal ultrasound will be performed to track its movements. The ultrasound uses soundwaves to create pictures of your internal organs that will show the dye as it moves along the fallopian tubes.

If a blockage is found in one or both of your fallopian tubes then you may need further tests to identify the exact cause. It may be possible to remove the blockage surgically, but if not then it can be bypassed with IVF treatment. During IVF, eggs are collected from your ovaries and the embryos are transferred directly into your womb so there is no need for them to move along the fallopian tubes.

Is it Painful?

The tubal patency test can cause some discomfort or pain that feels a bit like menstrual cramps. The procedure itself can also feel a bit uncomfortable because the instruments will need to be inserted into the vagina.

A speculum will generally be used to hold the vagina open so that the dye can be introduced into the uterus. If you have had a cervical smear test before then it will probably feel a bit similar. Some women may experience a cold sensation as the dye enters the womb. It can also cause period-like pain for some women.

The X-rays or ultrasound scans are themselves painless. The ultrasound does need to be performed internally, with an ultrasound probe that is inserted into the vagina, which can be a bit uncomfortable.

In order to help you feel as comfortable as possible during the test, your doctor might recommend taking a painkiller such as paracetamol or ibuprofen about half an hour before the scan. Everyone has different pain levels, but you should expect to feel some discomfort during the procedure.

Results

The results of your tubal patency test should be available within a few days, depending on the clinic that is performing them. If any issues were discovered during the scan then your fertility specialist will explain what they mean for your fertility.

If the fallopian tubes are clear then it indicates that there must be another reason for your fertility problems. The other tests that you have during your fertility assessment may help to identify the cause, but in some cases it is not possible to find a specific reason why you are having trouble conceiving naturally.

If a blockage is discovered during tubal patency tests then your doctor may recommend further tests such as a laparoscopy to find out more. Sometimes it is possible to remove the blockage so that eggs are able to move freely though the fallopian tube. You may then be able to conceive naturally. If this is not possible or the treatment doesn’t help then you may be able to have IVF to help you to get pregnant.

How Can We Help?

Our experienced fertility doctors can advise you on which fertility tests you should have. We can arrange tubal patency tests in the UK or overseas if you’re worried about your fertility or having trouble conceiving. We can also help you with the next steps if the results reveal that you need extra help to get pregnant.

If you want to arrange a tubal patency test or other fertility checks, get in touch to talk to one of our fertility specialists. We’ll help you to get the tests you need.

Tubal Patency Tests FAQ

The term tubal patency refers to the fallopian tubes that lead from each of the ovaries to the uterus. Patency describes tubes that are open and functioning correctly. Sperm needs to be able to travel along these tubes to reach the egg. The fertilised egg must then move down the tube to implant in the uterus. If there is a blockage preventing this from happening then it can cause infertility so a tubal patency test is often performed as part of female fertility tests.

If there is a blockage in the fallopian tube it could prevent sperm from reaching the egg or make it impossible for the fertilised egg to move into the uterus so that it can implant itself there. However, most women will have two ovaries that are each connected to the uterus through their own fallopian tube. As long as one of the tubes is open and connected to a functioning ovary, you might still be able to conceive naturally. However, it could take a little longer as eggs may only be released by one of the ovaries each month so your doctor might recommend fertility drugs to help. You might also be at increased risk of ectopic pregnancy if the tubes are partially blocked.

If both of the fallopian tubes are affected then it may be impossible to conceive naturally unless the tubes can be opened surgically. When this isn’t possible or doesn’t work, you will still have the option of IVF treatment which can avoid the need for eggs and sperm to travel along the fallopian tubes.

Approximately 40% of women who have fertility problems will have an issue with the fallopian tubes. Sometimes it is possible to remove the blockage surgically. In other cases, IVF treatment can enable women to conceive despite their fallopian tube problems.

Fallopian tubes can be blocked for various reasons, including endometriosis, STI infections, abdominal surgery, or previous ectopic pregnancies. The most common cause of fallopian tube blockages is Pelvic Inflammatory Disease or PID, which happens when an untreated infection leads to scarring. The fallopian tubes will also be blocked if you have had a tubal ligation procedure to prevent you from getting pregnant.

It may be possible to remove scar tissue or other blockages from the fallopian tubes with surgery, but this doesn’t always work. The chances of success are higher for younger women and when there are few blockages along the fallopian tube. If treatment doesn’t work then IVF treatment can enable women to conceive despite fallopian tube blockages.

You might experience some cramps during or after a tubal patency test. Some pinkish discharge is also common. In a small number of cases there could be an injury to the uterus or an infection might develop after the scan. Signs of infection that you should watch out for include fever, faintness, bad smelling discharge and severe cramps. There is also a small risk that you could have an allergic reaction to the dyes used during the procedure.

If you are having a tubal patency test using X-rays rather than ultrasound then there are some additional risks to consider. You will be exposed to X-rays and a radioactive dye. The low doses that are used shouldn’t cause any problems, but it is important to be aware that overexposure to these forms of radiation over the course of a lifetime can cause problems. Your doctor will want to be sure that you are not pregnant before you have a tubal patency test because of these risks. The dose of radiation that you will be exposed to is so small that it won’t cause any harm, but doctors are more cautious about exposing unborn babies to X-rays and other types of radiation as they are more sensitive.

If a problem is detected during a tubal patency test then it may be possible to clear the blockage with surgery. Another option would be to have IVF treatment so that you can get pregnant despite the blockage. You will need to discuss these options with your doctor so that you can make the right choices about your care. It will depend on the likelihood of success for surgical repair and whether there are any other fertility issues (including male fertility issues affecting your partner) that might require you to have IVF treatment even if the blockage is cleared.

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