Tubal patency testing with contrast agent

The aim of the patient information leaflet is to provide information on tubal patency testing and its potential risks.

One of the causes of infertility can be a partial or complete blockage of one or both fallopian tubes.

The most common reasons for blocked fallopian tubes include:

• pelvic inflammatory disease;

• sexually transmitted diseases, especially chlamydia and gonorrhoea;

• abdominal surgeries;

• ectopic pregnancy;

• endometriosis, etc.

Tubal patency testing involves assessing tubal patency using a special contrast agent, guided by an ultrasound. The test is performed in the first phase of the menstrual cycle. The test is an alternative to other tubal patency assessment procedures, such as laparoscopy or X-ray scans.

Tubal patency testing is performed by a gynaecologist on an outpatient basis without surgical intervention and with local anaesthesia. The examination is performed on a gynaecological examination chair. The gynaecologist inserts a gynaecological mirror into the vagina and numbs the cervix with an anaesthetic. The surgeon then inserts a catheter into the cervical canal and removes the mirror, injecting a prepared ExEm® foam (contrast agent) into the uterus through the catheter. An ultrasound probe inserted into the vagina displays the contours of the fallopian tubes and uterus on a screen. The test, including preparation, takes 15-20 minutes. You may feel slight discomfort and pain during the test.

The ExEm® foam consists of 5 mL of ExEm® gel and 5 mL of ExEm® purified water (see Figure 1).

Figure 1. Preparing the ExEm® foam (contrast agent)

Contraindications to the use of the ExEm® foam (contrast agent)

Do not use the ExEm® foam (contrast agent) if you have:

• pelvic inflammatory disease, sexually transmitted infections, severe bleeding;

• allergy to the ingredients of the ExEm® gel – hydroxyethyl cellulose, glycerol, purified water.

Results of tubal patency testing

If the fallopian tubes are not blocked, the ExEm® foam moves from the fallopian tubes to the abdominal cavity, where it is absorbed within 24 hours. After the procedure, your gynaecologist will immediately discuss the results with you.

If you have any questions or would like more information, please contact a gynaecologist at the Fertility Treatment Centre.

ITK1201

Approved by the decision of the Care Quality Commission of East Tallinn Central Hospital on 12.06.2024 (protocol no. 9-24)