Which test is used to assess tubal patency in infertility work-up?

Which test is used to assess tubal patency in infertility work-up?

• A. Hysterosalpingography (HSG) or Laparoscopy
• B. Semen analysis
• C. Pelvic ultrasound
• D. CA-125 testing

Answer: (A)

Testing tubal patency in infertility is typically done with imaging or direct visualization to determine if the fallopian tubes are open. Hysterosalpingography uses contrast injected through the cervix and uses X-ray imaging to track the flow through the uterus into the tubes. If the contrast spills freely into the peritoneal cavity, the tubes are patent; if there’s no spill or delayed flow, a blockage is suggested. This approach is less invasive and can be done in an outpatient setting, though it can cause cramps and carries a small risk of infection. If the results are unclear or a more definitive assessment is needed, laparoscopy with chromopertubation is performed. In this procedure, a camera is placed in the abdomen to directly visualize the pelvis, and dye is injected through the cervix to observe whether the dye passes through the tubes. This not only confirms patency but also evaluates other pelvic factors such as endometriosis or adhesions, making it the most definitive test for tubal and peritoneal factors. Other options in infertility work-up, like semen analysis, assess male factor infertility; pelvic ultrasound can detect structural abnormalities but does not reliably prove tubal patency; CA-125 is a tumor marker and not used to assess tubal openness.

Testing tubal patency in infertility is typically done with imaging or direct visualization to determine if the fallopian tubes are open. Hysterosalpingography uses contrast injected through the cervix and uses X-ray imaging to track the flow through the uterus into the tubes. If the contrast spills freely into the peritoneal cavity, the tubes are patent; if there’s no spill or delayed flow, a blockage is suggested. This approach is less invasive and can be done in an outpatient setting, though it can cause cramps and carries a small risk of infection.

If the results are unclear or a more definitive assessment is needed, laparoscopy with chromopertubation is performed. In this procedure, a camera is placed in the abdomen to directly visualize the pelvis, and dye is injected through the cervix to observe whether the dye passes through the tubes. This not only confirms patency but also evaluates other pelvic factors such as endometriosis or adhesions, making it the most definitive test for tubal and peritoneal factors.

Other options in infertility work-up, like semen analysis, assess male factor infertility; pelvic ultrasound can detect structural abnormalities but does not reliably prove tubal patency; CA-125 is a tumor marker and not used to assess tubal openness.