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Other tests that were commonly used in the past to assess female
infertility are no longer recommended. These include post coital testing of
cervical mucus and endometrial biopsy. These tests have not been found
to be predictive of reproductive success.
If you are curious about your inability to conceive, and schedule an
appointment with one of InVias Board Certified physicians at one of our
four Chicagoland locations.
When is TC indicated?
TC can be done when there is proximal tubal occlusion (PTO; the tubes are
blocked at the uterine end). Patients with distal tubal occlusion (the tubes
are blocked at the fimbrial end) often have hydrosalpinx and are NOT
candidates for TC. TC is not indicated when there has been a tubal
ligation. In patients with salpingitis isthmica nodosa; TC should be
deferred as IVF is the treatment of choice in these patients.
the tubal ostia (see above; C). It is then advanced past the occluded
portion of the tube into the distal tubal lumen and is moved in a to and fro
manner to further open up the tube. This is similar to what a plumber
does to open up a blocked pipe!
Does it hurt?
The discomfort experienced during TC is not much different than a HSG.
We pre-treat patients with Ibuprofen 800 mg and give a local anesthetic
(paracervical block) to further reduce any discomfort.
Essure HSG. Patients can now have a tubal ligation using hysteroscopy.
Using the Essure technique, a metallic coil is inserted into the tubal
lumen. The coil in turn induces fibrosis and blocks the tube. A HSG can
be done 3 months later to confirm that the Essure device is in place and
the tubes are blocked.
Scar tissue (adhesions) around the tube cannot be definitely diagnosed
with HSG. When there is a localized collection of dye (loculation); these
can be suspected. Pelvic endometriosis cannot be diagnosed with HSG.
The ovaries cannot be visualized on HSG. The uterine wall itself also
cannot be seen on HSG. These require a combination of ultrasound and
laparoscopy for a definite diagnosis.
At InVia Fertility Specialists, we use all three modalities (as needed) to
comprehensively evaluate our patients.
A bicornuate uterus
is another commonly seen uterine malformation. It can cause the baby to
lie sideways or breech. It is associated with premature delivery.
Hysterosalpingography
Posted on June 10, 2013 by Dr. Vishvanath Karande
The inner lining of the fallopian tubes can also be evaluated. The
presence of folds (rugae) in the tubes is a sign of a healthy tube.