The tube is where the egg meets the sperm. The Fallopian tubes do more than just be open. They are alive and functioning organ with an endothelial lining which is important to provide best surroundings for the egg to unite with the sperm. A fertilized egg spends the first couple of days in the Fallopian tube before moving into the uterine cavity. Thus it is obviously very important cog in the fertility-machine.
Traditionally patency of the fallopian tube was determined by laparoscopic tests wherein methylene blue dye was passed through the cervix and was visualized coming out of the openings of the fallopian tube. Gynecologists also use “hysterosalpingography” (hSG) which injects a radio-opaque dye and check the patency by taking X-rays. This can be done without anaethesia in the X-ray clinic. But it means going to another centre (as radiology needs a specialised facilities).
With evolution of USG techniques, the hSG to be replicated using sono-opaque dye and the patency is confirmed by transvaginalultrasonogrpahy done at the same time.
At our center we use echo sonography as the first line of investigation for tubal patency. It not only tells us that the dye passes through the Fallopian tube (tubal patency) but also gives us some information about the size of the tube and alerts about the possibility of tubal pathology like hydrosalpinx.
If necessary we would advise an hSG (hyseterosalpingography – dye test with X rays) or laparoscopy. This is if we suspect a pathology on the echo-sonography, but we need that only a few times. This policy saves our clients un-necessary running around and additional costs.
The echo-sonography (or other tubal patency tests- laparoscopy and dye or HSG) are done after the end of the menses but within the first 10 days of the cycle.