Evaluation of Fallopian Tube Patency Infertility and ART Failure

Up to one third of infertility and subfertility causes are due to impaired tubal patency. Tubal and peritoneal diseases are the main causes of infertility. Tubal pathology can either be congenital malformation or acquired; proximal or distal; unilateral or bilateral; and, transient or permanent. Several imaging methods such as laparoscopy, fluoroscopy, saline infusion sonography, and hysterosalpingography (HSG) have been used to assess tubal and peritoneal pathology. Although laparoscopy is the modality of choice for investigating tubal patency and pelvic structure in many infertility
centers, HSG is usually the initial diagnostic method for infertility workup because of its ease of performance, accuracy, and minimal risk of complications. HSG provides useful information about the size, contour, and anatomy of the inner surface of the fallopian tubes and is the gold standard for evaluation of tubal lumen. Tubal and peri-tubal pathology show various imaging manifestations on HSG. In this lecture we will discuss the radiographic features of congenital and acquired structural abnormalities of the tubal pathology, and the etiologies of occlusion or obstruction.