There are a number of things that need to work properly in order for a pregnancy to occur. Simplified, these include ovulation, sperm and open tubes.

If just one of these is not as it should be, then there is a high chance that there will be problems getting pregnant. Tubal testing is popular to determine if the fallopian tubes are patent (open).

When the fallopian tube is blocked, sperm is unable to reach the egg in order to fertilise it. If fertilisation of the egg does take place, and there is a problem with the tubes, then the egg may not be able to reach the uterus in order to produce a viable pregnancy.

Tubes can be blocked for a number of reasons, but there are several different forms of tubal testing that your doctor can perform in order to assess the extent of the problem.

Lap and Dye 

A laparoscopy (key hole surgery in the tummy) and dye test, often referred to as a ‘lap and dye test’, is a key hole surgery done whilst you are asleep. The dye test is used to check if there are any blockages in your fallopian tubes. The benefit of the laparoscopy is that it can also look for other gynaecological conditions that may be hindering your ability to conceive, such as endometriosis, polycystic ovaries, fibroids, adhesions and signs of old pelvic inflammation.

Small incisions are made on either side of the lower abdomen and through the belly button. Carbon dioxide gas is used to expand the abdomen so the doctor can do a full examination of pelvic organs. A laparoscope is placed through the abdominal wall, and blue dye is passed through the neck of the womb to check the fallopian tubes for blockages.

Tubal Testing: HSG

A HSG (hysterosalpingogram), another type of tubal testing, uses an X-ray to look at the uterus and fallopian tubes. This is a quick procedure that takes around 10 minutes. This is usually done in the first part of the menstrual cycle up to day 14. Whilst this procedure can check the tubes are open, unlike the lap and dye procedure it is unable to facilitate the treatment of any blockages or other conditions that may affect fertility.

During the procedure, you will be asked to lie down under a fluoroscope (X-ray imager). Your doctor will use a speculum to locate and clean the cervix. A cannula (a thin plastic tube) will then be gently inserted into the cervix and the speculum removed. A contrast liquid, which shows up on x-ray, is then injected into the womb cavity and x-rays are taken. Providing the tubes are open, this contrast will show up the fallopian tubes and uterus on an X-ray, with spill of the contrast out of the ends of the tubes into the abdominal cavity. This test cannot look for any problems with the womb, ovaries or in the pelvis.


A HyCoSy is a test which uses an ultrasound scan machine and dye to check whether the fallopian tubes are blocked or damaged. Unlike a HSG, the HyCoSy does not use X-rays and can image the other structures in the pelvis such as the ovaries and womb. The HyCoSy is a relatively short procedure, taking around 30 minutes, and does not need a general anaesthetic. A thin plastic tube is placed into the womb via the cervix, and an ultrasound bubble solution is passed down the tube into the womb, where it then flows into the fallopian tubes. An ultrasound looks at the progress of the fluid into the tubes to determine if the tubes are open or blocked.

Following reversal surgery, it is advisable to have a HyCoSy test around 3-6 months post-op.

The purpose of the HyCoSy is to ensure the tubes have remained open following the surgery and also to flush out any debris/ mucus or skin cells that may be blocking the tubes, preventing the sperm and eggs from meeting. There are many studies showing an increase in pregnancies following this procedure.

A HyCoSy would normally cost £500 in most fertility clinics, however, if you have undergone a reversal with Mr Dobson, it can be booked for the reduced fee of £325 and performed following your surgery. (For any patients who have previously had a Tubal reversal with Mr Pickles, this test can also be booked at this discounted rate on request.)

For anyone else who wants to check if their tubes are blocked or not and have not previously been under Mr Dobsons care, then it can be booked for the normal price of £450.


Which of the above tests your gynaecologist or fertility specialist will offer you will depend on your medical history and the services available in your local hospital or clinic. All the tests have the same purpose, to ascertain any problems with your fallopian tubes so that the most appropriate fertility treatment option can be identified. For more information please get in touch.