Fallopian tubes is a place where fertilisation takes place and thereby results in a pregnancy. So these tubes can be blocked due to various reasons such as infections, endometriosis, surgery or even congenital cause. So how do we come to know if there is a block? It is very important that when a person is faced with the problem of infertility to go for a tubal patency test. There are several methods how a tubal patency can be confirmed. That is to see whether the tubes are open or not. So these tests are usually carried out after the menstrual period and before day 10 to day 12 of the cycle. So ideally once the menstruation stops it is better to approach the fertility specialist to ensure as to which test might suit you best. Some of the tests that are available in the market include a HSG or Histo Salpingogram. So this is a test where a dye is passed through the uterus and the spillage is seen on an X ray where the dye spills out of the tube into the abdomen. This spillage is visualised on an X ray. This is very important as it not only shows that both the tubes are patent but it may also show any abnormalities of the uterus or it may also show where the tubule block is if at all there is a block and such a picture can be captured on an X ray and visualised. However the disadvantage is that we use a dye and there is 1% chance of reaction to the dye that may take place and apart from that it is also very painful. However this can be done under anesthesia as well. So HSG is very important and it is necessary to do these tests even before you start the treatment. Apart from that the test that is most commonly used nowadays and much safer alternative is the SSG or Sono Salpingogram. In this saline is inserted into the uterus and its spillage is visualized with the help of an ultrasound machine. It is much less painful than an HSG as this saline is normally in the same pH as the body fluids. Apart from that there are very minimal risks of any infection taking place or any reaction taking place as well. All these can be done as an OPD procedure and there is no need for day care admission. Apart from that we also have laparoscopy. Laparoscopy is the gold standard for all tubal tests. It is not a test that can be done on a day to day basis as it involves the risk of anaesthesia and it is a surgery, though it is a minimally invasive surgery. In this a very small kind of a camera is passed into the abdomen and a dye called methylene blue is injected from below and the spillage of this dye is directly visualised in the abdomen. The advantage of these tests are direct proof that the tubes are patent and we are actually seeing the spillage of the dye within the tubes and the other thing is that if there is a block it can be corrected in the same sitting as well.

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