Inability to conceive a child experienced by a couple even after living together and trying for the same is considered as infertility. One of the major causes for this condition is the block in the fallopian tubes. If the tube is completely blocked the sperm will not able to reach the egg and fertilize it. But in cases of partial block the sperm may reach the egg and fertilization may take place. But it is possible that the embryo may not reach the uterus and may be trapped inside the fallopian tube. This is a dangerous condition known as ectopic pregnancy.
Causes of tubal obstruction
The main cause for tubal obstruction is infection. Infections are usually caused by appendicitis or peritonitis. Infection can also be caused by a difficulty in the previous delivery or termination of the previous pregnancy or miscarriage. About 15 % of women who face infertility are found to have tubal problem. If there is medical history indicating tubal obstruction tubal patency will be carried out immediately. In other cases where there is no clear indication of tubal obstruction other diagnostic tests will be conducted before opting for tubal patency test.
There are three types of tubal patency tests. They are gas insuflation, hysterosalphingography and laparoscopy.
Gas insufflation is the oldest method in practice for conducting tubal patency test. This test is also known as blowing the tubes. This is a simple test.
With the help of an instrument inserted into the tract of the cervix, carbon dioxide gas is blown into the uterus. If the tubes are blocked the pressure inside the uterus will be increased. But if the tubes are open the pressure inside the uterus will dip immediately as the gas can escape through the tubes into the abdominal cavity. However the result of this test is not conclusive and the position where the block is experienced cannot be found out by this method.
An X-ray of the fallopian tube and uterus is known as hyterosalphinogram. Using a special instrument passed into the cervical canal a radio opaque dye is injected into uterus. An X-ray photograph is taken after the dye is injected. The X-ray will clearly show the cavity of the uterus and the passage of fallopian tubes clearly where the dye has passed through. This X-ray will clearly show the passage of the fallopian tube and the location of obstruction, if any. Even though this test can clearly show the spot of obstruction and any irregularity in the shape of the uterus cavity, this test will not be able to find out the details of adhesions, if any.
This is a comprehensive procedure than the earlier mentioned procedures. This procedure is done under general anesthesia. A small cut is made near the naval of the patient. The abdominal cavity is then inflated by blowing carbon dioxide gas into it for getting more space for clearly viewing the organs and structures contained therein. Now a laparoscope which is an instrument with a camera is inserted to the abdominal cavity and carefully guided to the target area. With the help of this instrument all the important organs like uterus fallopian tubes, ovaries etc are inspected. The existence of adhesions can clearly be visualized. The special advantage of this method is that it provides the surgeon an opportunity to view the uterus and connected organs and take proper decisions.