These tests are:

• Hysterosalpingogram (HSG)
• Sonosalpingogram (SSG)
• Diagnostic Laparoscopy and hysteroscopy

A HSG is an x-ray procedure to determine if the fallopian tubes are open and the shape of the uterine cavity is normal. A SSG is similar to a HSG but is an ultrasound.

HSG and SSG are performed on day 5-12 of the menstrual cycle when menstruation has ceased and ovulation has not yet occurred, so early pregnancies are not disturbed. The procedures involved the insertation of a vaginal speculum (the same as a cervical screening test). A fine tube is then gently inserted through the cervix and into the uterus allowing dye to be passed into the uterus and tubes.

If you chose an HSG you can choose between a water-soluble iodine-containing contrast or a water-soluble iodine-containing an oil-based solution called Lipiodol. A study reported in 2017 has shown that Lipiodol has improved live birth over the ensuing six months and possibly even longer in couples with fertility. The use of Lipiodol incurs extra costs.

If you chose a SSG the dye is a solution of sugar-like molecules known as ExEm Foam.

Diagnostic laparoscopy is keyhole surgery to examine the abdominal and pelvic cavities. The procedure performed under general anesthesia, and you can generally go home that day.

Compared to HSG and SSG, diagnostic laparoscopy is a more comprehensive procedure as endometriosis can be diagnosed or scar tissue around the tubes detected. It does have more risks (injury to other structures for example) and is more inconvenient. Lipiodol can be inserted at the time of the laparoscopy.

Both procedures are associated with mild or moderate uterine cramping for about 5 minutes after the procedure and sometimes during the procedure.

Occasionally, women experience cramps for several hours. These cramps can be reduced with non-steroidal anti-inflammatory drugs.

The most serious risk is an infection and can occur if the fallopian tubes were previously damaged.

To avoid infection, you may be asked to take antibiotics the day before and the day of your procedure. Tubal infection is uncommon.

Want to know more? Speak to your Care Fertility doctor or GP to understand if it's the right fertility test for you.