To confirm whether or not one or both fallopian tubes are blocked, your doctor may perform one of these two procedures:
- Hysterosalpingogram (HSG): Tubal factor infertility is usually investigated first with an HSG which is an X-ray examination performed by a radiologist. A speculum is used to open the vagina, then a catheter is inserted to inject liquid through your cervix (the opening into the uterus) into the uterus. If liquid comes out the ends of one or both of your tubes, then you can determine if one or both tubes are open. If the liquid does not enter or flow completely through one or both of your tubes, then the affected tube is considered blocked. It’s important to realize that if the test finds the fallopian tubes open, it does not mean that tubal function is normal. The inside lining of the fallopian tube may be severely damaged even though the liquid flows through the tube on the HSG. In addition, this test may falsely suggest that the tubes are blocked if blockage appears in the area where the tubes insert into the uterus (false positive). This false positive finding can occur in 15% of women.
- Laparoscopy: In this minimally-invasive outpatient procedure, a surgical instrument called a laparoscope is inserted through a very small incision below your belly button. The surgeon can look through the laparoscope to see if one or both of your tubes are open. The laparoscope can also be used to look for other problems that may affect fertility, such as scar tissue (adhesions) or endometriosis.