What Happens During A Selective Salpingography?

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Blocked or damaged fallopian tubes are a leading cause of infertility in women. Blocked fallopian tubes prevent conception (the fertilisation of an egg) because sperm cannot travel through the fallopian tubes to fertilise an egg. Also, a fertilised egg (embryo) cannot travel through your fallopian tubes to your uterus, where it can grow and develop into a healthy foetus. Open fallopian tubes are an essential requirement for conception to occur.


Understanding The New Technology of Selective Salpingography?

Use of selective salpingography to diagnose and unblock fallopian tubes has revolutionised the treatment of infertility. Selective salpingography uses a new technique for the diagnosis of fallopian tube abnormalities that can cause infertility. This technique can also be used to treat blocked fallopian tubes, which is also known as proximal tubal obstruction (PTO).


How Does a Selective Salpingography Procedure?

A selective salpingography procedure is usually done after a hysterosalpingogram (HSG) or at the same time. A HSG is an X-ray test during which your doctor injects a harmless dye into your uterus (womb), which should flow into the fallopian tubes. If you have a blockage, the X-ray will show that the dye does not flow into the fallopian tubes. 


What Causes Fallopian Tubes To Become Blocked?

Fallopian tubes are usually blocked by scar tissue or pelvic adhesions which can be caused by the following conditions:

  • A history of pelvic infection
  • A previous burst appendix
  • Having had a sexually transmitted infection (STI) such as gonorrhoea or chlamydia. Untreated gonorrhoea or chlamydia can result in pelvic inflammatory disease (PID) which can cause scar tissue and abscesses (pockets of infected fluid) to form in the reproductive tract.
  • Endometriosis, a condition that causes patches of endometrium (the lining of the womb) to grow outside of the uterus.
  • History of abdominal surgery
  • Past ectopic pregnancy. This can scar the fallopian tubes.
  • Fibroids. These benign (noncancerous) growths can block the fallopian tubes.
  • Hydrosalpinx, which is fluid blockage and swelling in your fallopian tubes


A Hysterosalpingography Diagnoses Blocked Tubes

A Hysterosalpingography (HSG) is usually the initial procedure performed in identifying potential blockages in the fallopian tubes. This X-ray procedure is used to view the inside of the uterus (womb) and fallopian tubes to see if the fallopian tubes are partly or fully blocked and if the uterus is a normal size and shape. A HSG is an X-ray dye that records images of your uterine cavity and fallopian tubes while they are filled with a special dye.

During a HSG a harmless dye is injected into the uterus. If the fallopian tubes are open, the dye will easily flow through the fallopian tubes and out of the ends. When dye does not flow into the tube(s) it can signify an obstruction or spasm of the muscle around the opening of the fallopian.


A Selective Salpingography Treats Blocked Tubes

The limitation of doing an HSG alone, is that it is impossible to distinguish an obstruction from a spasm (which is unimportant). Furthermore, an HSG alone can only diagnose an obstruction – it cannot remove it. The benefit of a selective salpingography is that it can both diagnose and treat fallopian tube blockages. Furthermore, it can demonstrate a normal, fallopian tube whose opening may be in spasm, but no blocked.


What Happens During A Selective Salpingography?

The medical name given to this procedure is “fallopian tube recanalisation by selective salpingography” as it involves clearing out any blockages in the fallopian tubes.



In preparation for this procedure, you can eat and drink as normal and take your normal medications. You will be required to start a short course of antibiotics before the procedure to minimise the risk of infection. The procedure can only be performed in days 1 - 10 of your menstrual cycle (counting the first day of your period as day 1).


Process of Selective Salpingography

Your radiologist or doctor will begin by cleaning your vagina with a gauze swab. A speculum will then be inserted into your vagina which allows a clear view of your cervix. A catheter (thin plastic tube) is then inserted into the cervix and used to inject contrast media (harmless dye) into the uterus (womb).

When a selective salpingography is performed a thin, flexible catheter is inserted within the HSG catheter which can then be directed into the opening of the fallopian tube. Once this is done, dye can be injected directly into the fallopian tube, where it can diagnose and treat any blockages by flushing them out with the dye. Injecting dye directly into the fallopian tubes (through a catheter) is more effective than injecting dye into the uterus (as with a HSG) as it can achieve a higher pressure. 

Regarding the success rate of this procedure, the average rate of pregnancy within 3 months of the procedure is 30%.

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