STEP 4. THE PERMEABILITY OF THE FALLOPIAN TUBES

This is the next step that sometimes takes decades for many couples who will check the tubes with unhealthy ardour any number of times in a variety of ways. Today there are 3 methods available allowing you to check the permeability of the fallopian tubes: laparoscopy, hysterosalpingography and sonohysterosalpingography. The terms are bulky and obscure, yet each of these investigations has a very clear role assigned to it. Thus, if we need to check the fallopian tubes, following a consultation and examination we (the doctors) will divide you into two groups:

• If you tell us nothing about the previous sexually transmitted infections (chlamydiosis, trichomoniasis, gonorrhea), if you have never had any operations on the pelvic organs, if you have no symptoms suggesting endometriosis, we will advise you to undergo sono-HSG or HSG. This will suffice to understand whether the fallopian tubes are permeable and to plan further treatment;
  
  
• If you have experienced all the above mentioned or if after US of the pelvic organs we suspect a hydrosalpinx, be ready that you will have to go onto a surgical table to undergo diagnostic laparoscopy. In this case, this surgery will not only enable us to see the condition of the tubes but will also inform us on the absence or presence of external genital endometriosis as well as allow us to evaluate the severity of an adhesive process and to remove the fallopian tube with pathological changes if needed.
  

Irrespective of the method we used to learn whether the tube is permeable or not, it will only give as much information, namely, whether it is PERMEABLE or NOT. Nothing more. We know that for an act of conception to be successful, the fallopian tube not only needs to be permeable, but also alive. It means that the tube must first deliver a sperm cell to the ovary and then transfer the fertilized egg cell back to the uterine cavity. This process is only possible when the villi of the tube are alive.

As you understand, the evaluation of the condition of the fallopian tube villi is not possible. Hence, having obtained the HSG or laparoscopy findings, we have information on the PERMEABILITY only, not on the functional «health» of the tube. In other words, the findings of these investigations will enable us to try and get you pregnant in a conservative way but if we do not attain it over two-four cycles, we switch over to the «big guns» - IVF!