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Dr Raelia Lew

Written by Dr Raelia Lew — Fertility Specialist & Gynaecologist

Published · 2 min read

Key takeaways

  • Fallopian tubes may be blocked by mucus, scar tissue, infection, endometriosis or distortion around the uterus.
  • Tubal flushing may improve natural fertility for three to six months after the procedure.
  • Flushing can occur by ultrasound-guided HyCoSy while awake or during laparoscopy under anaesthetic.
what is tubal flushing and does it HURT?

Sometimes fallopian tubes become blocked causing infertility.

Fallopian tubes are where egg and sperm meet for natural conception to happen.

Fallopian tubes pick up an ovulated egg, released from a woman’s ovary and propel the egg towards the uterus via peristalsis, a series of muscular contractions.

Sometimes fallopian tubes become blocked causing infertility.

Blockages can be relatively innocent, due to skin cell build up or a mucous plug. However other causes of blockages include adhesion (scar tissue) formation, after an infection like chlamydia, gonorrhoea or tuberculosis. Adhesions can also form after inflammation occurs due to endometriosis, endosalpingiosis or bacterian infections after a surgery (such as a dilatation and curettage procedure to manage a miscarriage).

Tubal blockages can also be functional, due to the presence of fibroids or adenomyosis causing distortion of the uterine anatomy around the area of the fallopian tubal isthmus (where the fallopian tubes enter the uterus or womb).

For some people, flushing your tubes can help you to get pregnant. Think of it like a good clean out, making it easier for egg and sperm to find each other.

Studies show improved natural fertility rates for infertile couples lasting 3-6 months after fallopian tubal flushing.

At Women’s Health Melbourne, our fertility specialists may recommend different ways of flushing your fallopian tubes.

One method is flushing under ultrasound imaging, known as a HyCoSy.

Another method includes flushing your fallopian tubes in the context of a planned laparoscopic and hysteroscopic full pelvic fertility focussed surgical assessment.

Which method is recommended depends both on your clinical circumstances and ultimately also on your preference.

Tubal flushing while awake under ultrasound can be desribed as very uncomfortable. The flush itself can cause uterine cramping. To achieve the flush (using either lipiodol or saline), your ultrasound doctor needs to place a vaginal speculum to access your cervix and will insert a small balloon catheter through your cervical opening in order to perform the flush with a good seal from below. It is recommended that you use pain relief medication before your procedure and rest afterwards.

If you are nervous about being awake for a tubal flush procedure, speak to your WHM fertility specialist about your preference for tubal flushing at laparoscopy, under a comfortable anaesthetic.


Considering Gynaecology?

Dr Raelia Lew and the Women's Health Melbourne team can talk through what's right for your circumstances.