Many women who seek fertility treatment are diagnosed with infertility due to an obstruction in one or both the fallopian tubes. Such obstruction can be caused by an infectious process, pregnancy, miscarriage (natural or dilated), endometriosis, as a result of abdominal and pelvic cavity adhesions following cesarean section or other surgeries. Uterine imaging with X-ray is the most common testing method in Israel today.
Who is the test meant for?
Examination of the fallopian tubes and the uterine cavity is recommended for all women who undergo observation for problems. Women who have already given birth in the past and women who are about to conceive for the first time.
Examination of the uterine cavity is also effective in diagnosing abnormal findings in the uterine cavity in cases of irregular bleeding or increased bleeding in women of all ages, due to the test’s ability to accurately sample the uterine cavity.
Ultrasound examination is a modern substitute for the uterine scan and is performed using the vaginal ultrasound. This is a test that gives reliable information on the health status of the uterine cavity and the fallopian tubes without the need to inject iodine-based materials and performing an X-ray.
How is the test performed?
The test is performed in the clinic and does not require preparation. During the examination, a great deal of information is obtained about the various pelvic organs, information that cannot be evaluated when performing a uterine scan.
The test consists of two parts. First, the uterine cavity is sampled by injecting sterile water into the cavity while simultaneously running the imaging with the help of an ultrasound test, also called hydrosonography. The water is injected into the uterine cavity through a thin and delicate tube which is placed through the vagina into the cervix.
ExEm foam is a special gel that allows seeing the pelvic organs that are important for the fertility process, which otherwise cannot be seen. The substance is approved by the US Department of Health, the European Standards Institute and the Israeli Ministry of Health, and has no known side effects. At the end of the test, the substance is discharged through the vagina.
What are the advantages of the test?
Excellent accuracy and diagnosis percentage (at least as accurate as a uterine scan) with the ability to control the dose of the injected substance.
The procedure is simple and easy and has virtually no side effects.
Since there is no need for a new test to grasp the cervix using a pinching device or pulling the uterus or inserting an intrauterine device – operations (common in uterine scanning) which can cause significant discomfort. Instead, a tube of a very small diameter is used and it is not necessary to insert it into the uterine cavity. The test can cause discomfort or tingling sensations that are described as similar to menstrual pain. For women who suffer from severe pain during menstruation, it is recommended to take an analgesic medicine about an hour before the test.
The need to use radiation or an iodine-based X-ray substance.
The test can be performed at any clinic. There is no need to use an iodine-based contrast agent, which can cause a severe allergic reaction.
During the vaginal ultrasound, performed as part of the test, it is possible to confirm that the base of the fallopian tubes is located in front of the ovaries (as it is supposed to be), an important detail that cannot be assessed when taking a uterus scan, since the ovaries are not sampled by an X-ray.
The analysis of the test is performed by the operating physician and includes providing a detailed written report for the attending physician immediately following the examination. In addition, every patient receives images of the test and a digital documentation where the dynamic passage of the fluid in both the uterine cavity and the fallopian tubes can be observed.
The test takes about 15 minutes.
The test can be performed up to a day before the ovulation, which is usually the 14th day counted from the start of the cycle.
Studies show that the test increases the chance of entering pregnancy naturally or through fertility treatments in the first months after it is performed!
