The simple idea (no memorising)
Recall the relay (Concept 29): the tube must catch the egg, host fertilisation, and carry the embryo to the womb. So "open" isn't enough — it must transport.
The usual first test is the HSG (hysterosalpingogram): dye is injected through the cervix and X‑rayed. If it spills freely out of the tube ends, the tubes are open.
The traps
- A blockage right where the tube meets the womb on both sides can be spasm, not a true block — so it shouldn't be called permanent without a second look.
- Never do an HSG during active infection (recall genital TB, Concept 28). 🚩
- A tube so damaged it fills with fluid — a hydrosalpinx — signals serious disease and can even lower IVF success, so it may need treating first.
What about the cervix?
Older work‑ups leaned heavily on cervical tests — sampling mucus after intercourse (the "postcoital test"), antisperm antibodies, and so on. Modern practice has largely dropped these as routine. Know they existed; don't build a work‑up around them.
The big‑picture links
Everything that scars tubes — PID, genital TB, endometriosis, past pelvic surgery — shows up here. So Parts 3–5 are exactly why a tube might be blocked.
Why it matters
Knowing whether the tubes work steers the whole plan: open tubes allow simpler treatments; blocked tubes point toward IVF, which bypasses the tube entirely (next concept).
Quick check ✅
- What does free spill of dye on an HSG tell you?
- Why must you never do an HSG during active infection?
Remember this 🌟
Where we're going next → When nature needs a hand, three techniques step in. Concept 33.