Description

Infertility affects a significant number of couples worldwide, and one of the common causes in women is blockage of the fallopian tubes. For fertilization to occur naturally, the fallopian tubes must be open and functional, allowing the egg and sperm to meet. A tubal patency test helps determine whether the fallopian tubes are open or blocked. Among the various methods, laparoscopy with chromopertubation is considered the gold standard. What is Tubal Patency Test by Laparoscopy? Laparoscopic tubal patency testing is a minimally invasive surgical procedure in which a laparoscope (a thin telescope-like instrument with a camera) is introduced into the abdominal cavity to directly visualize the uterus, fallopian tubes, and ovaries. During the procedure, a special dye is introduced into the uterine cavity to check whether it passes freely through the fallopian tubes into the abdominal cavity, confirming their openness. Procedure Anesthesia – The patient is usually under general anesthesia to ensure comfort. Laparoscope Insertion – Small incisions are made near the umbilicus to insert the laparoscope. Carbon dioxide gas is used to inflate the abdominal cavity for better visualization. Chromopertubation Test – A colored dye (commonly methylene blue or indigo carmine) is introduced into the uterine cavity via the cervix. Observation – The surgeon observes the flow of dye: If dye spills out freely from the fimbrial ends, the tubes are patent (open). If dye does not appear, it indicates tubal blockage (proximal, distal, or both). Additional Evaluation – The laparoscope also allows evaluation of pelvic organs for adhesions, endometriosis, fibroids, or other pathologies contributing to infertility. Advantages of Laparoscopic Tubal Patency Test Gold Standard Accuracy – Provides direct visualization of tubes and pelvic structures. Simultaneous Diagnosis & Treatment – Any adhesions, cysts, or endometriosis can be treated in the same sitting. Comprehensive Pelvic Assessment – Unlike HSG (Hysterosalpingography), laparoscopy evaluates both the internal and external anatomy of fallopian tubes. Minimally Invasive – Small incisions, faster recovery, minimal scarring. Limitations Requires anesthesia and an operating room setup. More expensive compared to HSG or Sonohysterography. Involves surgical risks like infection, bleeding, or injury (though rare). When is it Recommended? Couples with unexplained infertility. Women with history of pelvic infections, tuberculosis, or pelvic surgeries. Suspected endometriosis or pelvic adhesions. After inconclusive results from other tubal tests such as HSG or SSG (Saline Sonography). Conclusion The tubal patency test by laparoscopy with chromopertubation remains the most reliable and comprehensive method to evaluate fallopian tube health in infertility workup. Its dual role in diagnosis and treatment makes it highly valuable, especially for women with additional pelvic conditions. Although it requires anesthesia and surgical expertise, the accuracy and added benefits make it the preferred choice in many infertility centers worldwide.