Echosalpingography (sonographic determination of fallopian tube patency)

A safe step towards the longed-for motherhood

Tubal factor (fallopian tube obstruction) is one of the most common causes of female infertility. It is in the fallopian tube that the egg meets the sperm, and if this path is blocked by adhesions, natural conception becomes impossible. To rule out or confirm this problem, gynecologists prescribe a check of tube patency.

At St. Luke’s Clinic, we use the most modern and safest diagnostic method — echosalpingography (sonographic determination of fallopian tube patency). This is a check using an expert-class ultrasound machine and a special sterile solution, which allows for a quick and informative assessment of the reproductive system.

Why is ultrasound diagnosis (echosalpingography) better than X-ray?

Previously, X-rays (metrosalpingography) were used to check the tubes, which involved radiation exposure to the ovaries and severe pain. Echosalpingography has undeniable advantages:

• No radiation exposure: ultrasound waves are absolutely safe for egg cells. Pregnancy can be planned in the same menstrual cycle in which the procedure was performed!
• Maximum comfort: the manipulation causes only mild discomfort (similar to a pulling pain during menstruation), which is much easier for patients to tolerate.
• Comprehensive assessment: in addition to tube patency, the doctor simultaneously assesses the condition of the uterus, endometrium, and ovaries in real time.
• Therapeutic effect: the introduction of fluid under pressure often breaks small, thin adhesions (“flushes” the tubes), due to which the chances of conception in the coming months rapidly increase.

When is the procedure prescribed?

The examination is a mandatory step in planning pregnancy and treating infertility. A gynecologist or reproductologist will refer you for echosalpingography if:

• Pregnancy does not occur within 1 year (or 6 months for women over 35) of regular sexual activity without contraception.
• You are preparing for intrauterine insemination (IUI) or ovulation stimulation (procedures only make sense if the tubes are patent).
• There is a history of pelvic infections, chlamydia, adnexitis (inflammation of the appendages).
• You have undergone surgical interventions on the abdominal organs (e.g., appendectomy) or pelvic organs that could have provoked the formation of adhesions.
• There is a suspicion of intrauterine synechiae or polyps.

How is the tube patency check performed?

The procedure is performed on an outpatient basis, in the first phase of the menstrual cycle (usually on day 7–11 of the cycle, when menstrual bleeding has completely stopped, and ovulation has not yet occurred).

1. The patient is placed in a gynecological chair. The doctor performs a standard examination and a basic ultrasound of the pelvic organs.
2. A thin flexible catheter (1-2 mm in size) is inserted into the uterine cavity through the cervix. This may be accompanied by a slight pulling sensation in the lower abdomen.
3. A sterile saline solution or a special contrast foam (ExEm Foam) is slowly introduced through the catheter.
4. Using an ultrasound transducer, the doctor observes in real time how the fluid fills the uterine cavity, moves through the fallopian tubes, and (if they are patent) freely flows into the abdominal cavity.

The entire procedure takes 15 to 30 minutes. You receive the result immediately.

How to prepare properly?

For the procedure to be safe and not cause inflammation, minimal preparation is required. Before echosalpingography, you need to submit:

• Smear for flora (vaginal purity degree) — valid for 10-14 days.
• Cytological smear (PAP test) — valid for 1 year.
• If necessary — tests for sexually transmitted infections (STIs).

2 hours before the examination, it is recommended to take an antispasmodic (in agreement with the doctor) to prevent fallopian tube spasm and avoid a false-negative result. After the procedure, you can immediately return to your usual activities.

Eliminate doubts and take a confident step towards motherhood. Sign up for an expert ultrasound check of fallopian tube patency at St. Luke’s Clinic.