Transcervical Catheterization of the Fallopian Tubes (TCFT)

Transcervical catheterization of the fallopian tubes (TCFT) is an X-ray-guided procedure that evaluates and clears a partly blocked tube. A thin, soft tube (catheter) with a fine guide wire passes through the cervix and into the uterus. The clinician guides it to the point where the fallopian tube joins the uterus. Live X-ray imaging (fluoroscopy) shows the path. In NaProTechnology practice, TCFT is paired with selective salpingography and a measurement of the pressure inside the tube (intratubal pressure).¹ Together, these tests show whether a tube is truly blocked or only appears blocked.

A standard HSG often reports a tube as blocked near the uterus when the tube is open. The tube can contract temporarily (spasm). A small plug of debris can stop the dye. The dye may also fail to fill the tube completely. TCFT measures the resistance to fluid flow through the tube, before and after the catheter passes. If the pressure falls to normal, the tube had a partial blockage, and the catheter cleared it. If the pressure remains high, the blockage is complete. A complete blockage requires closer surgical evaluation.

Hilgers and Yeung measured tubal pressure in 234 women with infertility.² After catheterization, pressure returned to normal in 76% of partly blocked tubes. It returned to normal in only 29.5% of fully blocked tubes.² When fully blocked tubes went on to surgery, the authors found true disease in the tube.² Most partial blockages clear with the catheter. Most complete blockages do not. Clinicians perform the procedure in the follicular phase, the first half of the cycle, before ovulation. For couples with a blockage near the uterus (tubal factor infertility), TCFT can reopen the path for natural conception without surgery. When the blockage is complete, care moves toward surgical repair. One option removes the blocked segment and joins the healthy ends (tubal anastomosis).

In NaProTechnology practice, clinicians monitor tubal pressure throughout the procedure. Standard tubal catheterization omits this step. The pressure reading turns a simple open-or-closed answer into a graded measure of the tube. TCFT becomes a test and a treatment in one visit.