Opening of tube found closed in HSG: Selective Salpingography

In standard HSG, it is possible that a slightly occluded section of a tube that can be opened easily may be misdiagnosed as blocked. Moreover, even an unblocked section may be seen as blocked. These are called “false positive results” in medical termination. Depending on such results of standard HSG examinations, many women think that their tubes are occluded and worry about it unnecessarily.

Thanks to developed technology, new devices, and modern techniques that are routinely used in our center, there are now new ways of showing that the tubes are open and further, new ways of opening small cohesions. The first one mentioned, is the pain-free HSG technique and the latter is called selective salpingography.

During HSG performed in Sisli Echomar, as the occurrence of spasms in the uterus is low, consequently the possibility of occlusion of the tubes due to spasm is also low. In addition, if necessary, selective salpingography is further performed in order to open the tubes or to show that tubes are open. No additional fee is requested for this practice.

American Society for Reproductive Medicine (ASRM) suggests that in some cases when tube is found occluded in HSG, the procedure should be continued with selective salpingography. Sisli Echomar is the first and unique center in Turkey, where these two techniques are applied as a routine practice, in accordance with the recommendations of ASRM.

In selective salpingography method, a thin, soft catheter, as the one used in angiography, is progressed through the cervix to the inlet of the uterine tube, and examination liquid is flushed directly into the tube. This process is totally painless and generally takes only 1-2 minutes. Selective salpingography does not impose any further side effect or complication risk beyond the standard HSG.

Thanks to selective salpingography, more than 70% majority of the tubes that had been observed to be occluded in the proximal part were opened, or proved to be already open. In the months following the HSG and selective salpingography processes, increase in pregnancy rates is observed if the tubes are open.

It should be pointed out that neither HSG nor selective salpingography can be used or in no way replace surgical procedures for the opening of completely occluded tubes, surgically tied tubes or hydrosalpinx.