Tests and Investigations for Blocked Fallopian Tubes


The fallopian tubes are absolutely crucial to achieve a natural pregnancy. Unfortunately, these extremely delicate structures are easily damaged or by a range of issues. So how could you know if there are problems with your fallopian tubes?

Blocked and damaged fallopian tubes are among the top causes of infertility. People most commonly hear about blocked fallopian tubes, and while that is certainly one possible problem, there are a number of other possible medical problems with the fallopian tubes that could be preventing conception. Fallopian tubes may be blocked for a number of different reasons, they may be damaged or swollen, or there could be damage to the actual structure of the tube preventing it from moving around freely or from moving the egg or embryo successfully along the tube.

Fortunately, there are highly specialised tests and investigations that allow experienced fertility specialists to determine accurately if there are problems with the fallopian tubes, and exactly what those problems are. This information allows fertility specialists to determine the best course of treatment for each patients specific situation.

Tests and Investigations

Tests and investigations to establish if there are problems with the fallopian tubes are not just routinely performed for every fertility patient, because these are invasive procedures.

Whether or not the tests are done depends on your individual fertility challenges and the fertility specialists’ professional assessment about the risk. This is based on a thorough review of your medical history, including previous surgeries, infections, injuries and illnesses, as well as how long you have been trying to fall pregnant, among others issues that could impact fertility.

If your fertility specialist believes that a test or investigation is the best way forward, there are also different options, depending on your unique situation. One is the HSG test, which is one of the most common options for looking at the fallopian tubes. Another option is surgery, but at Cape Fertility it is only considered if absolutely necessary. When it is necessary, we offer our patients keyhole surgery or minimally invasive surgery to ensure safe and effective surgery with minimal side-effects.

HSG test for fallopian tubes

HSG is the short name for the procedure called a hysterosalpingogram.

A hysterosalpingogram (HSG) is a procedure that uses an X-ray to look at your fallopian tubes and uterus. The fact that an x-ray is needed means that this test is done in the X-Ray department.

Here at Cape Fertility, our experienced radiologist will do this test for you at the radiology department at Kingsbury Hospital across the road from our clinic.

What does the HSG test for fallopian tubes involve?

This explanation will help you better understand the process, step by step.

The first step is to place a speculum inside of the vagina, similar to when a pap smear is done. A little catheter is also placed just through the cervix – the mouth of the womb, which is the area between the vagina and the uterus – and into the very entrance of the uterus.

The next step is to fill up the uterus with a special dye and to take an X-ray to observe what happens. If the contrast spills out at the end of the tubes, it indicates that the tubes are open all the way. This would be considered a normal HSG.

A HSG can also reveal blockages. It is also possible for debris of some kind to get inside the tube and cause a blockage. The HSG may flush out some of this debris, but it is not a way to treat blocked tubes.

In some cases, the fallopian tube may not be blocked, but rather swollen or damaged by infection. This is called a hydrosalpinx – “hydro” meaning water and “salpinx” being another term for a fallopian tube – and refers to when a tube has been damaged, usually by infection, causing it to swell up at the end and resulting in a lot of fluid accumulating in the tube. Hydrosalpinx is typically caused by a condition like endometriosis, a previous pelvic or sexually transmitted infection, or previous surgery.

A HSG can also reveal quite a bit about the uterus itself, which may provide an indication of whether a closer look inside of the uterus is required.

Is The HSG Test For Fallopian Tubes Painful?

Understandably, many of our patients are concerned that the HSG test might be painful.

It is an invasive procedure, and it is necessary to use a speculum, the device shaped like the bill of a duck which doctors use to open the walls of the vagina to examine the vagina and cervix. Putting in the catheter can cause cramping, and you can also expect some cramping when the dye is inserted.

However, different women experience it differently. Some women say that they don’t feel much, while others experience cramping like period pain. There are also women who experience a lot of pain and take painkillers after the procedure. You can also speak to your fertility specialists about taking painkillers before having the test.

Surgical Investigation

Another option for closer investigation of the fallopian tubes is surgery.

At Cape Fertility, surgery is only considered if absolutely necessary. This is determined only after a thorough review of your medical history, including previous surgeries, infections, injuries and illnesses, as well as how long you have been trying to fall pregnant, among many others issues.

When it is necessary, we offer our patients keyhole surgery or minimally invasive surgery. This involves only tiny little one centimetre cuts – or keyholes – on the lower part of the stomach.

What does the surgical investigation for fallopian tubes involve?

While under anaesthetic, a tiny little cut is made through the belly button and a camera is inserted into the stomach cavity. A few more tiny little one centimetre cuts on the lower part of the stomach allows the fertility specialist to operate in the stomach cavity.

Some dye is then injected into the uterus, much like during a HSG test. If the fallopian tubes are open, the dye spills out of the end of the tube and this can be seen with the camera.

This investigation can also allow fertility specialists to see scar tissue that might be trapping a tube, and this can even be removed to allow the tube to move freely again. Similarly, it can reveal blocked ends of the fallopian tubes and that could possibly also be corrected during the procedure.

The investigation also provides an opportunity to look around the rest of the pelvis for other potential problems such as endometriosis and treat them at the same time.

Treatment for Blocked Fallopian Tubes

Should the tests or investigations reveal problems with the fallopian tubes, your fertility specialist will be able to recommend the right treatment appropriate to your unique fertility challenges, which could range from fallopian tube surgery or In Vitro Fertilisation or IVF treatment.

Your next step

Your first step to getting a fallopian tube test or investigation done, is simply to contact us by clicking here…

At Cape Fertility, we value each individual patient and we look forward to providing you with individualised and personalised care, affordable quality fertility treatment, and higher success rates at our purpose-built premises in the beautiful city of Cape Town.