Tubal Patency / Saline Infusion Sonography

A Hysterosalpingogram is an ultrasound-based procedure performed to assess whether the fallopian tubes are patent or “open”. Fluid is passed into the tubes and can be visualized by ultrasound

Who may be offered a tubal patency study?

Tubal patency studies are a common part of the assessment of women who are experiencing difficulty conceiving.

How is it performed?
• An internal ultrasound is initially performed to examine the uterus, ovaries and pelvic structures to look for any causes of fertility problems. This will also confirm that ovulation has not occurred as the procedure cannot be performed in this instance. For this reason, the test is usually performed in the first half of the menstrual cycle (ideally day 5-10).
• A speculum is inserted into the vagina, as is used in a pap smear test.
• The vagina and cervix are cleaned with antiseptic solution
• A fine catheter is inserted into the uterus and a small balloon inflated to hold the catheter in place.
• The speculum is then withdrawn and the ultrasound probe reinserted into the vagina
• Sterile normal saline (salty water) is then injected via the catheter and can be followed on ultrasound as it passes along the tubes. The specialist performing the procedure can determine if the tubes are open from this and will inform the patient at the time of the procedure.

What are the side effects?

• Period-like discomfort is a common experience at the time of passage of the catheter and the opening of the balloon. Non steroidal anti inflammatory medication (eg Nurofen TM) taken 1 hour prior to the procedure is recommended to minimize this.
• Light vaginal bleeding can occur following the procedure. It will usually stop within 24 hours and pads rather than tampons are recommended during this time.
• The risk of infection is very small. Should vaginal loss become offensive or a temperature occurs, our rooms or your referring doctor should be contacted so that antibiotics can be arranged.
• Very rarely, some women experience dizziness when the catheter is inserted through the cervix or when the balloon is inflated. If this occurs the procedure may need to be abandoned. A past history of cervical shock or particular difficulty with pap smears is a contraindication to the procedure
• Occasionally it is not possible to pass the catheter through the cervix. In this situation, the procedure cannot be performed.

What happens after the test?

• The Ultrasound and test takes approximately 30- 40 minutes. We would like you to stay and rest for approximately 20 minutes afterwards.
• You may experience some some mild crampy, period-like discomfort following the procedure for an hour or two.
• You will be given a sanitary pad to wear for the rest of the day as there will be a small volume of blood-stained fluid leakage from the vagina.
• Most women are fine to return to work and normal activities following the test.
• Patients should abstain from sexual intercourse for 48 hours after the procedure.

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