X-ray tubal patency

The fallopian tubes have an important function in the female reproductive apparatus, connecting the uterus with the ovaries. It is in them that the egg cell meets with the sperm cell, is fertilized and moves into the uterine cavity in order to consolidate on the wall and begin to grow. This is the mystery of the birth of life. It happens that a woman can not get pregnant. To clarify the cause, it is necessary to conduct an examination, including an x-ray of the fallopian tubes.

Indications for the procedure

Uterine or fallopian (on behalf of the doctor Gabriel Fallopia, the first to describe their structure) tubes feed the embryo in the first days of its existence, as well as thanks to the cilia of the epithelium lining the walls, and their ciliated movements promote it into the uterine cavity. Its length is on average 11-12 cm. The fallopian tube is divided into 4 main segments:

1. infundibul, the end of which is the mouth of the fallopian tube;
2. ampular region;
3. isthmic part; and 
4. intramural or interstitial part, which is located in the wall of the uterus. [1]

If the desired pregnancy does not occur for a long time, there is a suspicion of obstruction of the fallopian tubes. The prevalence of obstruction of the fallopian tubes is 19.1% in the primary infertility group and 28.7% in the secondary infertility group. [2]It helps to reveal its diagnostic procedure, called hysterosalpingography (GHA).

Hysterosalpingogram (GHA) is a visualization method used to assess tubal patency in women with primary and secondary infertility. Tube pathologies can cause primary and secondary infertility. Based on several scientific studies, women with secondary infertility had a higher chance of obstruction of the fallopian tube with GHA than women with primary infertility.[3], [4]

Among the risk factors for infertility, previous operations on the pelvic organs were significantly higher in the controlled study of Romero Ramas et al. The prevalence of transferred chlamydial infection was very significant in women with secondary infertility.[5], [6]

In fact, hysterosalpingraphy is an x-ray using a contrast agent. It makes it possible to identify adhesions, myoma, other neoplasms, pressing on the outside and pinching the tube, or internal blockages due to tubal infections, congenital underdevelopment and other causes.[7], [8]

Indications for x-ray of the fallopian tubes are also:

• stimulation of ovulation, when using drugs to increase the secretion of hormones necessary for the release of an egg from the ovary;
• artificial insemination procedure (IVF).[9]

Preparation

X-ray examination of the female reproductive organs is carried out in the first 2 weeks after the end of the month. A week before the procedure, it is necessary to stop using vaginal ointments, suppositories, and intimate hygiene products. In the last 2 days - to refrain from sexual contact.

Technique of the salpingography

Immediately before the snapshot, the doctor examines the patient and inserts a stable into the uterus cervix - a tube of small diameter through which a contrast substance is poured into the uterus from the syringe (iodine-containing drugs are used for this: ultravist, triombrast, verographin) required for X-ray delay. The places where the liquid has penetrated are colored bright white in the picture, dark spots indicate obstruction.

Typically, women complain of minor pain in the lower abdomen and discomfort. To avoid this, local anesthesia is applied, the anesthetic is injected directly into the uterine cavity.

Next, take a few pictures, after which the tube is removed. [10]

Contraindications to the procedure

Hysterosalpingography is not performed during pregnancy, with complete obstruction of the fallopian tube, with internal infections, for the detection of which a bacteriological smear from the vagina is examined before the procedure. It is contraindicated in women with an allergic reaction to a contrast agent.[11], [12]

Complications after the procedure

Half an hour after the procedure, the patient returns to its normal state. Contrast fluid is absorbed into the bloodstream and is naturally excreted from the body without any negative effect and consequences on the state of health. Occasionally bloody or watery discharges occur, passing after 1-2 days, a few hours can hold a slight pain. There may be a slight delay in menstruation.

The roentgenoscopy of the fallopian tubes is associated with minimal complications, and yet they may be under the pressure of violating the sterility of the instruments or the failure to follow the rules of hygiene in the following days. Nausea, pain, heavy bleeding, fever - symptoms that give reason to immediately consult a doctor. Other complications include: venous intravasation [13], uterine perforation, infections, allergic reactions and urticaria [14], syncope, hemorrhage and shock, pulmonary embolism or retinal embolism [15], a case of hyperthyroidism [16].

Care after the procedure

There is no need for special care after the examination, however, some rules must be adhered to:

• exclude sexual relations for several days;
• not to take a bath, but only a shower;
• do not visit the sauna and bath;
• do not use tampons, but only pads.

Reviews

What is better, an ultrasound (ultrasound screening)  [17]or x-ray of the fallopian tubes? According to the study, the sensitivity of hysterosalpingography and sonogisterography is 58.2% and 81.8%, respectively. The specificity of hysterosalpingography and sonogisterography is 25.6% and 93.8%. Hysterosalpingography has a total accuracy of 50.3%, while sonohysterography has a significantly higher accuracy of 75.5%.[18]

Some people note that after the contrast substance gets into the tubes, the probability of getting pregnant increases, because they are washed out, cleaned of mucus, small adhesions are eliminated. [19], [20], [21]

The desire of women to become a mother is a natural need set by nature itself. Often they are capable of any test, just to give birth to a child. X-ray fallopian tubes, according to reviews, not the worst of them. Although each person has his own pain threshold, with the help of painkillers the procedure is not perceived as hard and lasts no more than a quarter of an hour.