Selective Salpingography

Selective salpingography tests each fallopian tube, one at a time, to determine whether it is open. A thin tube (catheter) passes through the cervix. The clinician guides it to the opening of each tube (tubal ostium) with X-ray imaging (fluoroscopy) or a hysteroscope. Dye then enters each tube separately to test whether the tube is open (patency).

A standard hysterosalpingogram (HSG) fills both tubes at once from the uterus. Selective salpingography tests each tube on its own instead. This gives a clearer view of the part of the tube closest to the uterus (proximal segment).¹²

The procedure can both diagnose and treat. For diagnosis, it confirms or rules out a blockage near the uterus seen on a standard HSG. HSG shows a meaningful number of false blockages in that segment, because the tube can spasm when dye enters.

For treatment, the catheter can pass through a confirmed blockage to reopen the tube (fallopian tube recanalization). The same session that finds the blockage may also clear it, with no surgery.¹²

This dual role makes selective salpingography especially useful in the evaluation of tubal factor infertility. A blockage near the uterus on HSG may prove to be real. It may also prove to be a false reading caused by spasm.

When the blockage is real, selective salpingography with recanalization offers a minimally invasive, restorative option. The transcervical catheterization technique is the basis of this procedure.¹