Feasibility and Efficacy of Office Hysteroscopic Fallopian Tube Functional Tests

Objectives: To assess how feasible and effective current hysteroscopic fallopian tube (FT) functional tests, namely bubble test, flow test, and proximal tubal peristalsis test, are in predicting FT status in apparently normal FT. Methods: A prospective bicentric cohort study done at the Endoscopy Units of tertiary university hospitals that included women with bilaterally apparently normal and patent FT on a previous diagnostic laparoscopy (DL) with successful tubal chromopertubation test, or hysterosalpingography (HSG) planned for office hysteroscopy (OH) for a variety of indications. They were subjected to vaginoscopic OH to access the cornual ends of the FT with observation of proximal FT bubble and flow patency tests and peristalsis on both sides. Main Outcome Measures were estimating the percentage of the success of hysteroscopic FT function tests in already proved patent FTs. Result(s): In 141 cases (98.6%), successful uterine cavity access was possible. In 134 cases (95%), access to Darwish Triad (DT) for the evaluation of various hysteroscopic tubal functional tests was feasible. A successful test was considered successful for prediction of proximal FT status. In terms of right and left FT, the bubble test was successful in 118 (88.1%) and 122 (91%) cases, and the flow test was successful in 68 (50.7%) and 67 (50%) cases, respectively. The peristalsis test was successful in 106 (79.1%) FT on both sides. There was an insignificant difference between successful hysteroscopic FT function tests in patients with prior patent FT diagnosed by DL or HSG. Conclusion(s): Vaginoscopic office hysteroscopy is a simple and effective tool for provisional assessment of proximal FT functions. Hysteroscopic FT patency and peristalsis testing are good indicators of anatomic and physiologic functions of the proximal FT. Both are superior to flow test. Proximal FT function testing would be a valuable addition to hysteroscopic examinations of infertile patients.