How can one know that the Fallopian tubes are blocked?

Unfortunately, most women do not have signs or symptoms suggesting tubal block. However, if you had previous infections in pelvis, tuberculosis in any part of the body, previous ectopic pregnancy, appendicectomy or gynaecological surgery, or feel severe pain during periods or during intercourse, there is a chance of tubal blockage. 

How the tubes are tested? 

Whether tubes are open (“patent”) or not, is usually checked by a special X-ray, called Hystero-salpingogram (HSG), in which a contrast material will be given through the neck of the uterus (cervix). It is cheaper and easily available. However, some women can feel discomfort during HSG. Usually some pain-relief medications are given during the procedure. 

Another method is Saline Infusion Sonography (SIS) or SSG, in which water is inserted inside the uterus with the ultrasound probe put inside the vagina (TVS). It is more accurate than HSG and causes less discomfort. Both HSG and SIS are done in out-door basis, without any need of anaesthesia. 

When Laparoscopy is advised? 

If HSG or SIS show both the tubes are blocked, then the only way to confirm the blockage is by laparoscopy. This is, because, sometimes, the spasm of the muscles of the tube during HSG or SIS can lead to “false positive” result; that means if tubes are found to be blocked by those tests, the tubes may actually be found open actually during laparoscopy. 

Laparoscopy is also advised to check the tubal patency, if there are other reasons (like removal of cyst or severe pain) or when HSG or SIS could not be done for technical difficulties. 

Laparoscopy is done under general anaesthesia with two or three small opening (key-hole surgery) in the abdomen and a coloured material (“dye”) is introduced through the uterus.